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Re: maternal hep B From: Efrain Ramirez (eramirezt@coqui.net) Tue Sep 30 15:34:17 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: maternal hep B" Previous message: Terrence.Jones@kp.org: "Re: maternal hep B" In reply to: Richard Chudacoff, MD: "maternal hep B" This is what ACOG says: I think it's rather clear.. "Perinatal Management. The combination of passive and active immunization, as outlined here, has been particularly effective in reducing the frequency of perinatal transmission of hepatitis B virus. Several investigations conducted in Asian nations have shown that passive and active immunization of the newborn is 85-95% effective in preventing perinatal transmission of hepatitis B virus. The Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend hepatitis B virus screening for all pregnant women. Pregnant women should be routinely tested for HBsAg during an early prenatal visit. If, at the time of admission to the hospital for delivery, the test has not been performed or the results are not available, the HBsAg test should be done. Women in high-risk groups who initially test negative for hepatitis B virus should be targeted for vaccination if they have not been vaccinated previously. Seropositive women should be encouraged to inform their children and sexual partners of the need for testing and vaccination. Serum transaminases should be measured in seropositive women to detect biochemical evidence of chronic active hepatitis. If the test results are abnormal or if the liver is palpable, the patient should be evaluated further to determine whether the disease is acute or chronic. The Centers for Disease Control and Prevention recommends universal active immunization of all infants born in the United States (6). The immunization schedule for infants of women who have been screened and are negative should be started preferably before discharge, but by no later than 2 months of age. Infants of women who are known to be HBsAg positive or whose status is unknown should have both passive and active immunization treatment. It should be given simultaneously at different sites intramuscularly and started within 12 hours after birth. Such a strategy will prevent postnatal and neonatal acquisition of hepatitis B virus in most cases. The physician responsible for the care of a newborn delivered to a mother with chronic hepatitis B should be informed of the mother's carrier status so that the appropriate doses of hepatitis B virus vaccine and HBIG can be given as soon as possible following delivery." At Mon, 29 Sep 2003, Richard Chudacoff, MD wrote: > >Interesting discussion today in the doctors lounge: 6-month-old infant >develops fulminate hepatitis and liver failure. Noted to have Hep B. Records >reviewed noted that mother was Hep B positive, but this was not acted upon >by OB. Aunts and grandmother are also Hep B positive-none with active >hepatitis. Infant never received hep vaccine in hospital, or by >pediatrician. Fingers have been pointed. Who, if anyone, has the majority of >the responsibility, and why did the checks and balances (vaccination in >hospital, review of records, pedi vaccination) fail? > >Any comments? > >-- >Richard Chudacoff, MD, FACOG >Chudacoff Obstetrics & Gynecology, PLLC >15200 Southwest Freeway, #270 >Sugar Land, TX 77478 > >Tel: 281-277-3900 >Fax: 281-277-3901 > >rchudacoff@mylinuxisp.com >Richard.Chudacoff@obgyn.net > >http://www.mdhub.com/281-277-3900 >http://www.chudacoffobgyn.yourmd.com > >*****HIPAA Confidentiality Notice***** > >The documents inside this electronic transmission contain confidential >information belonging to the sender that is legally privileged. This >information is intended only for the use of the individual or entity named >above. The authorized recipient of this information is prohibited from >disclosing this information to any other party and is required to destroy >the information after its stated need has been fulfilled, unless otherwise >required by law. > >If you are not the intended recipient, you are hereby notified that any >disclosure, copying, distribution, or action taken in reliance on the >contents of these documents is strictly prohibited. If you received this >electronic transmission in error, please notify the sender immediately to >arrange for return. > -- "The opposite of a correct statement is a false statement. But the opposite of a profound truth may well be another profound truth." Niels Bohr (1885 - 1962) Next message: Richard Chudacoff, MD: "Re: maternal hep B" Previous message: Terrence.Jones@kp.org: "Re: maternal hep B" In reply to: Richard Chudacoff, MD: "maternal hep B"

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