Can I have a natural birth if I have hepatitis B?

Everyone knows that hepatitis B is contagious and can be transmitted from mother to child. Therefore, many pregnant women with hepatitis B are particularly worried about infecting their babies and afraid that they will not be able to give birth naturally. In fact, hepatitis B is not as serious as imagined. As long as you give birth in a regular professional hospital and usually take timely preventive measures after the baby is born, it will generally not be transmitted to the baby.

Can a normal birth be achieved with hepatitis B?

1. If liver function is normal, DNA virus is negative, and the fetus is normal: In this case, hepatitis B is less contagious or even not contagious. In addition, the fetal size, placental function, and amniotic fluid are all normal, so pregnant women with hepatitis B can give birth naturally.

2. If the pregnant woman has abnormal liver function, or the viral DNA is positive, but the fetus is normal: In this case, the pregnant woman with hepatitis B needs to go to a regular hospital and receive liver protection drug treatment under the guidance of a doctor to restore liver function to normal. If the pregnant woman has liver disease and pregnancy-induced hypertension syndrome, she can only give birth naturally if the disease is under control through treatment. Otherwise, pregnant women with hepatitis B will need to have a caesarean section, which is safer.

3. If the fetus is abnormal: You need to go to the hospital at this time, and the obstetrician will use B-ultrasound and fetal monitoring to understand the size of the fetus, the function of the placenta, and the amount of amniotic fluid to determine the method and time of delivery. For normal pregnancy, primiparas will have regular uterine contractions with an intermittent period of 5 to 6 minutes, which gradually intensify. At this time, it is more appropriate for pregnant women with triple positive to be admitted to the hospital for delivery early.

Blocking mother-to-child transmission

The hepatitis B virus does not infect the fetus at the beginning. Studies have confirmed that more than 80% of intrauterine infections occur in the late pregnancy. Therefore, if a pregnant woman is found to have hepatitis B after pregnancy, she can receive medication treatment after 7 months of pregnancy to reduce the risk of mother-to-child transmission of the hepatitis B virus, and the impact on the fetus will be minimal.

Hepatitis B immunoglobulin ≥ 100 IU should be injected as soon as possible within 24 hours after the fetus is born (preferably within 12 hours after birth), and the hepatitis B vaccine should be administered again at different sites. The second and third doses of hepatitis B vaccine should be administered at 1 month and 6 months respectively.

Injection of hepatitis B immunoglobulin can immediately eliminate the hepatitis B virus that enters the baby's body through maternal blood contamination, so the sooner the better, preferably within 12 hours after birth. This combined immunization method of hepatitis B immunoglobulin + hepatitis B vaccine can increase the mother-to-child transmission rate of hepatitis B to 95%.

However, when using the combined immunization method of hepatitis B immunoglobulin + hepatitis B vaccine, it is necessary to pay attention to the following:

① The dose of hepatitis B vaccine for children born to mothers with hepatitis B is twice as large as the dose for ordinary children.

②Since the hepatitis B vaccine is part of the hepatitis B virus surface antigen, and hepatitis B immunoglobulin is the antibody that neutralizes this antigen. If injected at the same site, the antigen and antibody neutralize each other and lose their original effects. Therefore, hepatitis B immunoglobulin is best injected before hepatitis B vaccine and at different sites.