Antenatal screening of women for hepatitis B and C in an out-patient department

ABSTRACT

To determine frequency of hepatitis B virus [HBV] and hepatitis C virus [HCV] and its clinical manifestation in pregnant women. A cross-sectional descriptive study. Pregnant women visiting the Gynaecology and Obstetrics out patient's department of Sir Ganga Ram Hospital Lahore for antenatal check-ups from October 2006 to March 2007 were screened for hepatitis B and C. Immune- chromatography was used for initial screening and diagnosis was confirmed by ELISA technique. Data collection included maternal age, parity, symptoms or past history of jaundice, fatigue, tiredness, insomnia, depression, dyspepsia, fever, anorexia and pale stool. Risk factors investigated include past history of some surgical procedures, the dental visit, blood transfusion, tattooing, hospitalization and history of injection. Among the screened population, 7.3% out of 2439 ladies were positive for anti HCV and 2.2% for HBsAg while dual infection with HBV and HCV was observed in 0.08%. Symptoms observed in hepatitis B patients were fatigue [90%], depression and pale stool [70%], anorexia [60%], jaundice [57.2%], fever [56.4%] and dyspepsia [51.2%]. In hepatitis C antibody positive patients fatigue was the main symptom [95.7%] followed by pale stool [84.5%] and depression [80.2%]; 63.3% had insomnia, 59.1% had anorexia, 50.7% had fever, 50.7% had jaundice and 43.6% had dyspepsia. Past history of blood transfusion was reported by 32.3% patients, surgery by 42.2% and tattooing was observed in 0.70%. One or more tooth extraction was reported by 50.2% subjects, and 49.25% had history of repeated injections. The frequency of sero-positivity for HBsAg and HCV among pregnant women is alarming. These sero-positive mothers are not only predisposed to chronic consequences of hepatitis, but also are a continuous threat to their off springs and care providers. Hence, there is a direct need for further epidemiological studies and to take measures for prevention and control of the disease