Hepatitis B and pregnancy. Part 1. Thirteen practical issues in antenatal period

• Published in: Journal de gynecologie, obstetrique et biologie de la reproduction Vol. 45; no. 6; pp. 531 - 539
• Main Authors: Fouquet, A, Jambon, A-C, Canva, V, Bocket-Mouton, L, Gottrand, F, Subtil, D
• Format: Journal Article
• Language: French
• Published: France Elsevier Masson 01-06-2016
• Series: Journal de gynecologie, obstetrique et biologie de la reproduction
• Subjects: Adult; Female; France; Hepatitis B, Chronic - diagnosis; Hepatitis B, Chronic - drug therapy; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Life Sciences; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - drug therapy; Amniocentesis; Antiviral treatment; Traitement antiviral; Serovaccination; Sérovaccination; Amniocentèse; Pregnancy; Prevention; Grossesse; Prévention; Hépatite B; Maternal-fetal transmission; Transmission materno-fœtale; Hepatitis B
• ISSN: 0368-2315; 1773-0430
• DOI: 10.1016/j.jgyn.2016.02.004

In France, the prevalence of chronic hepatitis B is about 1% in pregnant women (usually asymptomatic carriers of HBsAg). The risk of maternal-fetal transmission of hepatitis B is particularly high when viral load measured by PCR is higher in mothers (above 7 log) or HBeAg is present. In case of maternal-fetal transmission of hepatitis B, the risk to the newborn of developing subsequent chronic hepatitis B is very high (90%), with long-term complications such as cirrhosis and hepatocellular carcinoma. The prevention of maternal-fetal transmission is based on systematic testing for hepatitis B during pregnancy, followed by serovaccination of the newborn at birth. If necessary, amniocentesis can be realised but will avoid the realization of a transplacental gesture. In case of high viral load, the establishment of a maternal antiviral treatment with lamivudine or tenofovir from 28SA can further reduce the risk of transmission. Given the low resistance it induces, tenofovir should be used preferentially.