Precautions that expectant mothers who are Hepatitis B carriers should take during childbirth are vital in minimizing the risk of transmission of the virus to the baby and protecting the health of both the mother and the newborn.
Proper practices and medical precautions during childbirth can ensure a healthy start for the baby.
1. Choice of Delivery Method
Vaginal Delivery or Cesarean Section:
- The method of delivery does not affect the risk of Hepatitis B transmission. However, the delivery method should be chosen based on the mother's overall health and obstetric factors.
- The doctor determines the most appropriate method based on the mother's liver condition and HBV DNA levels.
2. Newborn Protection Protocol
Measures taken immediately after birth significantly reduce the risk of the virus being transmitted to the baby:
Hepatitis B Vaccine:
- The baby should receive the first dose of the Hepatitis B vaccine within the first 12 hours after birth.
Hepatitis B Immunoglobulin (HBIG):
- If the mother is HBsAg positive, HBIG should be administered to the baby along with the vaccine.
- HBIG provides passive protection to the baby's immune system, creating immediate defence against the virus.
3. Mother's Treatment Status
Antiviral Treatment:
- If the mother's HBV DNA level is high (usually >200,000 IU/mL), antiviral treatment started in the third trimester should be continued to reduce the risk of transmission to the baby during delivery.
Monitoring of Liver Function:
- The mother's liver health should be closely monitored during delivery. If there are complications such as cirrhosis or liver failure, additional measures should be taken.
4. Informing the Delivery Team
Mother's HBsAg Status:
- The healthcare team delivering the baby should be informed about whether the mother is a Hepatitis B carrier.
- This information ensures that necessary protective measures for the newborn are taken in a timely manner.
Emergency Protocols:
- Emergency plans should be prepared for mothers at risk of complications during delivery.
5. Breastfeeding Precautions
Starting Breastfeeding:
- If the baby has been vaccinated after birth, breastfeeding is generally safe.
Breast Care:
- If the mother has cracked or bleeding nipples, precautions should be taken against the risk of infection, and this situation should be shared with the doctor.
6. Postpartum Follow-up
Baby's Vaccination Schedule:
- After the first dose of vaccine and HBIG, the baby's vaccination schedule should continue at 1 and 6 months.
- After the vaccination schedule is completed, the baby's HBsAg and anti-HBs levels should be checked at 9-12 months of age.
Mother Follow-up:
- The mother's liver function should be monitored during the postpartum period, and antiviral treatment should be continued if necessary.
7. Education of parents and providing information
- The mother should be informed about the precautions to be taken during delivery and the newborn vaccination schedule.
- The steps required to protect the baby should be explained in detail.
