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Gynaecology & Obstetrics Medical Illness Complicating Pregnancy caeb0a41

A patient at 14 weeks pregnancy, on her routine antenatal panel, tests positive for HBsAg. Which of the following is true about her condition?

A
Significantly increased maternal morbidity
B
High risk of IUGR and IUD
C
HBsAg is the first serological marker of this illness
D
Lamivudine is the first line drug
High-Yield Explanation
Hepatitis B in pregnancy Not a cause of excessive maternal morbidity and moality The first serological marker to be detected is the hepatitis B surface antigen (HBsAg), often preceding the increase in transaminase levels. Patient is often asymptomatic and diagnosis is usually incidental on routine antenatal screening No increased risk of IUGR or pre ecclampsia Transplacental viral infection is known but is uncommon. There is more risk if HBeAg is positive Lamivudine is not a drug of choice since it is associated with high chance of development of resistant mutation. Tenofovir and Telmivudine are preferred. Breast feeding is not totally contraindicated especially in developing countries like India since the lack of breast milk is likely to be more detrimental that the likelihood of infection. Also, transmission rate is very low if baby is vaccinated.

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