Hepatitis B, caused by the HBV virus, can be transmitted through blood, sexual contact, and from mother to child. Women with chronic hepatitis B can still conceive and deliver healthy children, provided their viral load is controlled and liver function remains stable.

Before planning pregnancy, it is essential to consult a hepatobiliary specialist. This appointment will assess your HBV DNA viral load, liver enzymes, liver function, and current medications. Do not discontinue medication independently when preparing for conception, as this could lead to a viral rebound and elevated liver enzymes, impacting the mother's health. While some antiviral medications are safe for use during pregnancy, others may require a switch prior to conception.

If the viral load is reduced, liver enzymes are stable, and there are no signs of progressive liver damage, you can plan pregnancy with your doctor's guidance. However, if the viral load remains high or liver enzymes are abnormal, the individual should undergo more intensive treatment to achieve better control before attempting to conceive.

Bac si Cong provides pre-marital reproductive health counseling to a woman. Illustration: Tam Anh General Hospital

Your partner should also be tested for hepatitis B. If he is not infected and lacks immunity, he should receive the full course of vaccination to prevent transmission. This underscores the importance of pre-marital health screening for couples before starting a family, particularly when one partner is aware of having a chronic infectious disease.

During pregnancy, you must inform your obstetrician at the initial visit about your chronic hepatitis B status and whether you are currently on or have previously used antiviral medication. The pregnancy should be collaboratively monitored by both an obstetrician and a hepatobiliary specialist. In the final months, if the viral load remains elevated, the doctor may prescribe medication to minimize the risk of mother-to-child transmission.

Mothers with hepatitis B are not automatically required to have a C-section; the delivery method depends on the mother's obstetric condition and the fetus's health. The most critical measure to protect the newborn is vaccination against hepatitis B within the first 24 hours after birth, often along with hepatitis B immune globulin as prescribed. The infant must receive all subsequent vaccine doses and undergo immune response testing when appropriate.

Dr. CKI Nguyen Van Cong

Obstetrics and Gynecology Unit

Tam Anh Cau Giay General Clinic