Ob/Gyn Medical News about Hepatitis B Virus Infection; Pregnancy; Screening

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Screening for Hepatitis B Virus Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement
Annals of Internal Medicine, 06/16/09

Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for hepatitis B virus hepatitis B virus infection in pregnancy. The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits and harms of screening pregnant women for hepatitis B virus infection. The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit. (This is a grade A recommendation.)

Screening Tests: Serologic identification of hepatitis B surface antigen (HBsAg). Reported sensitivity and specificity are greater than 98%.

Timing of Screening:

Order HBsAg testing at the first prenatal visit.
Rescreen women with unknown HBsAg status or new or continuing risk factors at admission to hospital, birth center, or other delivery setting.

Interventions:

Administer hepatitis B vaccine and hepatitis B immune globulin to HBV-exposed infants within 12 hours of birth.
Refer women who test positive for counseling and medical management.
Counseling should include information about how to prevent transmission to sexual partners and household contacts.
Reassure patients that breastfeeding is safe for infants who receive appropriate prophylaxis.

Implementation: Establish systems for timely transfer of maternal HBsAg test results to the labor and delivery and newborn medical records.

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