Should I pay out of pocket for the injection of hepatitis B immunoglobulin?
Hello Doctor: I am a pregnant woman who is a carrier of hepatitis B (surface antigen HBsAg is +...1330; e antigen HBeAg is -...0.25).
Will there be a risk of vertical transmission to the fetus? Is it necessary to administer hepatitis B immunoglobulin within 24 hours after the baby is born? If the immunoglobulin is not administered, is breastfeeding not allowed? I kindly request your response.
Thank you.
PP, 30~39 year old female. Ask Date: 2006/12/27
Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: It is recommended to get vaccinated.
However, online Q&A is for reference only; please discuss with your attending physician before making a decision.
Thank you! Hsinchu City Hospital, Department of Obstetrics and Gynecology.
Reply Date: 2006/12/27
More Info
When it comes to managing Hepatitis B in pregnant women, particularly those who are HBsAg positive and HBeAg negative, the risk of vertical transmission to the newborn is a significant concern. However, the current medical guidelines suggest that the risk of transmission is relatively low in cases where the mother is HBeAg negative. This means that while there is still a possibility of transmission, it is not as high as in cases where the mother is HBeAg positive.
In your specific situation, since you are HBsAg positive and HBeAg negative, the general recommendation is that the newborn does not necessarily need to receive Hepatitis B immunoglobulin (HBIG) immediately after birth. The statistics indicate that the risk of the infant contracting Hepatitis B from an HBeAg negative mother is significantly reduced, which is why the administration of HBIG is not routinely recommended in these cases. However, the newborn should still receive the Hepatitis B vaccine within 12 hours of birth to provide active immunity.
If you are considering self-paying for the administration of HBIG for your newborn, it is indeed an option. The cost is typically around $1,800, and while there are generally no significant side effects associated with HBIG, it is always prudent to discuss any concerns with your healthcare provider. They can provide you with personalized advice based on your specific health circumstances.
Regarding breastfeeding, mothers who are HBsAg positive can still breastfeed their infants. The transmission of Hepatitis B through breast milk is considered to be very low, especially if the infant has received the appropriate vaccinations. Therefore, if your newborn receives the Hepatitis B vaccine and you are not HBeAg positive, breastfeeding is generally safe and encouraged.
In summary, while the risk of vertical transmission of Hepatitis B from an HBsAg positive, HBeAg negative mother is low, it is still crucial to follow the recommended vaccination schedule for the newborn. The infant should receive the Hepatitis B vaccine within the first 12 hours of life, and while HBIG is not routinely required, it can be administered if desired. Breastfeeding is safe and recommended, provided that the infant has been vaccinated. Always consult with your healthcare provider for tailored advice and to address any specific concerns you may have.
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