Major medical groups have issued new guidelines for clinicians caring for pregnant women who have hepatitis C virus (HCV).
None of the direct-acting antiviral treatments for hep C are approved for use in this population, unfortunately.
The Society for Maternal-Fetal Medicine published the guidelines in the American Journal of Obstetrics & Gynecology. The guidelines have been endorsed by the American Congress of Obstetricians and Gynecologists.
The guidelines are directed at obstetric care providers, advising them to:
- Test women who are at increased risk for HCV at their first prenatal visit. If the woman initially tests negative but has ongoing risk factors, retesting is advised. Women who do have hep C should receive screening for sexually transmitted infections and should be vaccinated for hepatitis A and B viruses (HAV/HBV).
- Lower the risk of mother-to-child transmission of hep C among women living with the virus according to the following principles: 1) Counsel women who request invasive prenatal diagnostic testing that data are limited regarding the risk of hep C transmission associated with such testing and that amniocentesis is preferred over chorionic villus sampling; 2) Hep C itself is not a reason to opt for a cesarean section birth; 3) Clinicians should avoid internal fetal monitoring, prolonged rupture of membranes and episiotomy.
- Treat women with DAAs after they give birth. Note: HCV-positive women may safely breast-feed.
To read a press release about the recommendations, click here.
To read a quick rundown of the recommendations, click here.