Hepatitis and Pregnancy

Hepatitis is the medical word for an infection of the liver.  Actually, hepatitis can be caused by drugs as well, but for the most part when we speak of it we mean a disease caused by viruses.

As you may have heard, there are several types of viral hepatitis, spread in several different ways.  As new viruses are discovered that cause this disease, the alphabetical list of them keeps growing.

Hepatitis A is the main one we worry about in travelers.  It is very common in many parts of the world to which people travel.  It is spread in the food and water and you get it by eating raw or improperly cooked foods and drinking contaminated beverages.  Hepatitis A is now the number one disease to result in hospitalization and lost work in returned travelers.  Although it is a mild illness in children, it can be devastating and life threatening in adults, especially pregnant women.  A pregnant woman who gets hepatitis A is much more apt to get seriously ill, and the infection may cause premature labor or the premature separation of the placenta (abruption) resulting in a major hemorrhage and death of the baby.

This type of hepatitis is easily prevented by vaccination and, as we mention in the chapter on immunizations, this vaccine is safe and effective during pregnancy.

Hepatitis B, the other common type of viral hepatitis, is spread through blood and body fluid contact.  Most travelers think that they are safe from this as they do not expect to use drugs, receive blood transfusions or have sex with the natives.  But this type of hepatitis is rapidly taking over the place of importance previously enjoyed by hepatitis A.

Remember that in many developing countries hepatitis B is so common that over 90% of the population shows signs of having had the infection.  Then remember that in some studies as many as one out of sixty foreign travelers receive injections during their trip, many of them in countries where sterility of medical equipment is downright abysmal.  Finally, remember that it doesn’t take a needle poke to get the disease.  Body piercings, tattoos, shaves in a barber shop, sharing razors and sharing toothbrushes are all common ways for people to get this disease.

Hepatitis B, too, is an important disease during pregnancy because it can cross the placenta and infect the baby.  And the baby may be infected for life, suffering permanent liver damage or even liver cancer.

This type of hepatitis can also be prevented with a vaccine that is safe to get during pregnancy.

Unfortunately, the same cannot be said of the other forms of viral hepatitis.  Hepatitis C and D are both blood-borne, spread in the same fashion as hepatitis B and just as easily.  But not as easily prevented. 

Hepatitis E is quite new on the scene and it is rapidly becoming a worldwide disease.  Like hepatitis A, it is spread in contaminated water.  And it is devastating in pregnancy.  In some epidemics, as many as half of the pregnant women who get it will die of the disease.

All of this to emphasize that pregnant women need more than anyone else to take the precautions necessary to prevent hepatitis.  This includes getting the necessary shots, being very careful of what you eat and drink, and avoiding needles of any sort, including body piercings.