Intrapartum hepatitis B screening

OBJECTIVE: The purpose of this study was to determine the prevalence of acute hepatitis B in intrapartum patients and to describe the birth-to-administration interval of the hepatitis B vaccine and immune globulin in hepatitis B surface antigen-positive patients detected by intrapartum screening. STUDY DESIGN: Hepatitis B screening was performed on 8712 laboring patients admitted to Forsyth Memorial Hospital in Winston-Salem, North Carolina, between July 1, 1992, and Jan. 31, 1994. RESULTS: Fourteen laboring patients had positive results for hepatitis B surface antigen (prevalence 0.16%), and two of the 14 had a profile consistent with acute disease. The average interval from birth to administration of the hepatitis B immune globulin and hepatitis B virus vaccine was 18.6 hours (range 3.9 to 31.0 hours) for hepatitis B virus-infected patients whose hepatitis B surface antigen status was unknown before labor. CONCLUSION: Intrapartum screening allows for diagnosis of the asymptomatic patient with acute hepatitis B virus infection whose hepatitis B surface antigen status was unknown before labor who would not have received hepatitis B immune globulin had only early prenatal screening been performed.