Of all the serious liver diseases in pregnant women, hepatitis is the most common. Hepatitis refers to a group of liver infections usually caused by viral pathogens. There are at least six different types of viral hepatitis, each one caused by a different agent:
- hepatitis A (caused by the hepatitis A virus);
- hepatitis B (caused by the hepatitis B virus);
- hepatitis C (caused by the hepatitis C virus);
- hepatitis D (caused by the delta viral agent that needs hepatitis B to establish infection);
- hepatitis E (caused by the hepatitis E virus); and
- hepatitis G (caused by the newly discovered hepatitis G virus).
Hepatitis A and E are both transmitted by fecal-oral contamination through person-to-person contact. Poor hygiene is usually involved, with food (such as contaminated shellfish) or water being the vehicle by which the virus is transmitted. People typically contract these infections while traveling in an area where there is an outbreak of hepatitis or through contact with an infected person.
Women with hepatitis B, C, D, or G have usually been exposed through sexual contact with an infected partner or intravenous exposure to contaminated blood. In the U.S., the latter typically involves the sharing of needles between drug users.
Hepatitis B, C, D, and E can all be transmitted from the mother to her baby during pregnancy. Hepatitis A and E are usually not associated with transmission to the fetus.
Hepatitis B, C, and D (and perhaps G) have carrier states-meaning that someone can carry the virus without having the disease and can transmit it to others.
Although there are differences between these diseases, often in the acute (early) phases, they can be very similar. The following symptoms are common to all forms of viral hepatitis:
- malaise (a general feeling that you are sick);
- decreased appetite;
- darkened urine;
- jaundice (yellowing of the skin and the whites of the eyes); and
- pain on the right side of the abdomen, over the liver.
Up to one-third of patients develop chronic hepatitis (infection lasting longer than six months) and cirrhosis (scarring of liver tissue). Other potential complications of viral hepatitis include encephalopathy (degenerative brain disease) and coagulopathy (blood clotting disorder). Hepatitis B and C can lead to liver cancer.
Each type of hepatitis has different effects on the pregnant mother and her baby. Some types cause virtually no risk to the fetus while others can be quite serious. Also, the presence of hepatitis can affect the decision to breast feed. Therefore, it is important for your doctor to determine which type of hepatitis you have so that the proper treatment for you and your baby can begin.