Guidelines for Prenatal Care

  1. Screen every pregnant woman for HBsAg early in each pregnancy according to Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists (ACOG) recommendations. HbsAg testing should be repeated late in pregnancy if the woman is HBsAg negative and is at high risk of hepatitis B infection (e.g., injection drug user, infected with other sexually transmitted diseases, having multiple sexual partners).
  1. Report every HBsAg-positive pregnant woman within three working days to the Tacoma-Pierce County Health Department on the 24-hour reporting line (253) 798-6534. This is a required reporting condition according to WAC 246-101-101. Health Department staff provides case management and follow-up services for infants and family members.
  1. Counsel each HBsAg-positive pregnant woman about:
    • How hepatitis B spreads
    • How to prevent hepatitis B
    • The need to get medical follow-up with a liver specialist
    • Need for infant to receive:
      • HBIG and hepatitis B vaccine within 12 hours of birth.Two additional doses of hepatitis B vaccine at 1–2 months of age and at 24 weeks of age.
      • Post-vaccine screening at 9–12 months of age to confirm the baby is protected. Or 1-2 months after final dose of vaccine series if the series is delayed. If the series is delayed, post-vaccine serology should be collected 1–2 months after the final dose.
    • Need for screening of household contacts and sexual partner for hepatitis B. Vaccinated, if susceptible, at intervals of zero months, one to two months, and four to six months.
  1. Report every HBsAg-positive woman to the hospital prior to admission for delivery to assure her infant will receive appropriate post-exposure.