Hepatitis C virus, pregnancy and postnatal care

Infection with hepatitis C virus (HCV) has a relatively benign effect on maternal health in the absence of liver cirrhosis or intra-hepatic cholestasis of pregnancy. Cell-mediated immunity diminishes during pregnancy, inadvertently lowering serum transaminase levels and increasing HCV viral load. Rates of transmission from an infected woman to her newborn are relatively low and may occur intrauterine, intrapartum, or during the postnatal period. No interventions during pregnancy or at the time of delivery have been shown to reduce the risk. Hepatology nurses play a pivotal role in developing clinical and communication pathways between hepatology and obstetric services. In contrast to obstetric care, hepatology care of women with HCV extends beyond pregnancy, encompassing long-term monitoring of HCV and associated liver disease, access to anti-viral treatments, ongoing counselling, education, advocacy and support