Hepatitis Testing for Pregnant Women in Kathmandu — Protecting Mother and Baby Screening in pregnancy prevents mother-to-child transmission.

Overview: Why Hepatitis Screening Matters in Pregnancy

Hepatitis B and C screening during pregnancy is one of the most important preventive health measures for protecting newborn babies. Hepatitis B can be transmitted from mother to child during pregnancy, childbirth or breastfeeding, and without intervention, up to 90% of infants born to hepatitis B-positive mothers may develop chronic infection. Hepatitis C transmission during pregnancy is less common but still possible, and new treatments now allow cure before or after delivery.

Hepatitis B screening in pregnancy is routine and recommended by WHO and most national guidelines. A simple blood test for hepatitis B surface antigen (HBsAg) detects current infection. If positive, additional tests determine viral load and liver status, and interventions — including newborn vaccination and antiviral treatment for high viral load — dramatically reduce transmission risk.

Hepatitis C screening is also recommended in pregnancy, particularly for women with risk factors such as blood transfusion, injection drug use, or partners with hepatitis C. While hepatitis C treatment during pregnancy is limited, identifying infection allows planning for treatment after delivery and prevents transmission through breastfeeding precautions where indicated.

This page covers what hepatitis tests are needed during pregnancy, when to get tested, what positive results mean, how transmission is prevented, and what support is available. All testing at Thamel Clinic is confidential, gentle and coordinated with your obstetric care.

Why Hepatitis Screening Is Essential During Pregnancy

Hepatitis B is highly infectious and easily transmitted from mother to child. Without intervention, the risk of transmission is approximately 90% if the mother has high viral load (HBeAg positive) and the baby does not receive vaccine and immunoglobulin at birth. With proper intervention — newborn vaccination, hepatitis B immunoglobulin (HBIG), and antiviral treatment for high viral load — the transmission risk drops to less than 5%.

Hepatitis C transmission during pregnancy is less common (approximately 5% risk) but increases if the mother has high viral load or HIV co-infection. While hepatitis C treatment is now highly effective with direct-acting antivirals, treatment during pregnancy is generally avoided. However, identifying hepatitis C in pregnancy allows planning for treatment after delivery and appropriate infant feeding guidance.

Screening also benefits the mother. Many women with chronic hepatitis B or C are unaware of their status and may have underlying liver disease that needs monitoring. Pregnancy can affect liver disease progression, and knowing hepatitis status helps obstetricians provide appropriate care throughout pregnancy and delivery.

• HBV transmission risk without intervention is up to 90% for high viral load mothers.
• Newborn vaccination plus HBIG reduces transmission risk to under 5%.
• Hepatitis C transmission risk during pregnancy is approximately 5%.
• Screening identifies liver disease that may affect pregnancy management.
• Treatment planning for after delivery becomes possible with early identification.

What Tests Are Needed During Pregnancy

The primary hepatitis B test is HBsAg (hepatitis B surface antigen), a blood test that detects current infection. If positive, additional tests including HBeAg (e antigen), HBV DNA (viral load) and liver function tests determine the stage of infection and transmission risk. HBeAg positivity indicates high viral load and highest transmission risk.

Hepatitis C screening uses anti-HCV antibody test. If positive, HCV RNA testing confirms active infection and measures viral load. Liver function tests (ALT, AST, bilirubin) assess liver health in both hepatitis B and C positive patients.

Hepatitis A immunity testing (anti-HAV IgG) may be considered if the patient has risk factors or if vaccination is planned. Hepatitis A vaccination is safe in pregnancy and recommended for susceptible women at risk of exposure.

• HBsAg blood test is the primary screening test for hepatitis B.
• HBeAg and HBV DNA determine viral load and transmission risk.
• Anti-HCV antibody screens for hepatitis C; HCV RNA confirms active infection.
• Liver function tests assess liver health in positive patients.
• Anti-HAV IgG may be checked if vaccination is considered.

What a Positive Hepatitis Result Means

A positive hepatitis B result does not mean you cannot have a healthy pregnancy or healthy baby. With proper management, most hepatitis B-positive mothers deliver healthy babies who remain infection-free. The key is identifying infection early, monitoring liver health, and ensuring the newborn receives vaccine and immunoglobulin immediately after birth.

For hepatitis B with high viral load (typically HBV DNA above 200,000 IU/mL or HBeAg positive), antiviral treatment with tenofovir during the third trimester can reduce viral load and dramatically lower transmission risk. This treatment is safe in pregnancy and is widely used for this purpose.

A positive hepatitis C result requires different management. Treatment during pregnancy is generally avoided, but the mother can be treated after delivery. Breastfeeding is considered safe for hepatitis C unless the mother has cracked or bleeding nipples or high viral load. Your clinician will discuss feeding options based on your individual situation.

• Positive hepatitis B does not prevent healthy pregnancy with proper management.
• High viral load may warrant tenofovir treatment in third trimester.
• Newborn must receive HBV vaccine and HBIG within 24 hours of birth.
• Hepatitis C treatment is typically deferred until after delivery.
• Breastfeeding decisions depend on viral load and nipple condition.

Preventing Mother-to-Child Transmission

The cornerstone of preventing hepatitis B mother-to-child transmission is the newborn prophylaxis package: hepatitis B vaccine plus hepatitis B immunoglobulin (HBIG) given within 24 hours of birth, followed by completing the vaccine series at 6, 10 and 14 weeks. This is part of Nepal immunization program but requires coordination for hepatitis B-exposed infants.

For mothers with high viral load, antiviral treatment with tenofovir starting in the third trimester (around week 28) reduces viral load before delivery. This significantly lowers transmission risk and is safe for both mother and baby.

Partner vaccination is also important — if the mother is hepatitis B positive, the father and other household contacts should be vaccinated if not already immune. This prevents household transmission and protects future pregnancies.

• Newborn HBV vaccine plus HBIG within 24 hours is critical.
• Complete vaccine series at 6, 10 and 14 weeks for exposed infants.
• Tenofovir in third trimester for high viral load mothers.
• Partner and household contacts should be vaccinated if susceptible.
• Coordination with pediatrician ensures proper infant follow-up.

Support and Counselling for Hepatitis-Positive Pregnant Women

Receiving a hepatitis diagnosis during pregnancy can be stressful. Many women worry about their baby's health, about stigma, and about whether they can breastfeed. At Thamel Clinic, we provide confidential counselling that addresses these concerns with accurate information and emotional support.

We coordinate with your obstetrician to ensure hepatitis status is included in your pregnancy care plan. This includes monitoring liver function, planning delivery, ensuring newborn prophylaxis is arranged, and discussing feeding options.

We also connect you with support resources and help you understand that hepatitis B is manageable — with proper care, both you and your baby can be healthy. Many hepatitis B-positive women have healthy pregnancies and healthy babies who never develop infection.

• Confidential counselling addresses fears about baby's health and stigma.
• Coordination with obstetrician ensures integrated pregnancy care.
• Newborn prophylaxis is arranged and explained before delivery.
• Breastfeeding guidance is provided based on individual circumstances.
• Support resources and follow-up care are connected as needed.

Hepatitis Testing in Pregnancy — Services and Costs

Prices are indicative and may vary by package. Confirm current rates when booking.

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