Infections & pregnancy
Protecting your baby
This leaflet explains about some of the infections that can cause problems for your baby, but which can be treated.
These are:
- human immunodeficiency virus (HIV);
- hepatitis B; and
- syphilis.
There are screening tests for all these infections and your midwife will offer you these.
The leaflet also gives information about protecting yourself from rubella (German measles).
You can choose whether or not you want the tests. The information in this leaflet will help you decide which tests you want to have. You can also talk about all the tests with your midwife and doctor before you decide, and ask about the local arrangements for the tests.
Screening tests for all these infections are recommended by the National Screening Committee – an expert panel set up to look at how effective screening tests are and the benefits of them.
How are the tests done?
Will my results be confidential?
What is HIV?
Should I have the screening test for HIV?
What will the screening test result tell me?
Does having the HIV screening test affect insurance policies?
What if I have HIV?
What is hepatitis B?
Should I have the screening test for hepatitis B?
What if I have hepatitis B?
What is syphilis?
Should I have the screening test for syphilis?
What if I have syphilis?
What is rubella?
What if I am not protected against rubella?
Why are the tests recommended?
Screening for HIV, hepatitis B and syphilis is offered and recommended in every pregnancy. If you have one of these infections and it is not treated, your baby could catch the infection from you during the pregnancy, the birth or after the birth.
All of these infections can be serious and if not treated may cause serious damage to the baby. Most people with these infections will not feel ill and will not know they have these infections. If you have one of these infections, treatment will significantly reduce the chance of your baby catching the infection.
How are the tests done?
The screening tests for HIV, hepatitis B, syphilis and rubella susceptibility (not protected against rubella) can all be carried out on one blood sample. You can choose which tests are carried out. Only a small amount of blood is needed. The blood tests are usually done in early pregnancy.
Why should I have the test?
By accepting screening for HIV, hepatitis B and syphilis you are deciding to find out if you have the infection so that everything possible can be done to protect your unborn child.
Where will the blood test be done?
Your midwife will tell you where you can have the test done.
Does screening have any risks?
Screening is a simple blood test. The only risk would be the same as having any blood test.
What if I decide not to be screened for HIV, hepatitis B or syphilis?
If you decide not to be screened for HIV, hepatitis B or syphilis your midwife may ask you the reasons why to make sure you have understood the reasons for the test. Later on in your pregnancy, your midwife may ask you if you want to discuss the screening and may offer you the test again.
You can ask to be screened for HIV, hepatitis B or syphilis at any time in your pregnancy.
How will I get the results of my screening tests?
Your midwife will tell you how and when you will get the result of the tests you choose to have.
Will my results be confidential?
The NHS keeps the results of all blood tests confidential. Hospital policies on how many people have access to your test results vary. Your midwife will be able to explain the local arrangements to you.
Human immunodeficiency virus (HIV)
What is HIV?
HIV is a virus that attacks the immune system. It is the virus that can lead to acquired immune deficiency syndrome (AIDS). A person infected with HIV can look and feel well for many years. They may not know they are infected unless they have a blood test. However, this virus can be passed on to the baby during pregnancy, childbirth or by breastfeeding.
How can HIV be caught?
HIV can be caught through:
- a mother who is infected passing it to her baby during pregnancy, the delivery or breastfeeding;
- any unprotected sexual activity (without a condom) with someone who is infected;
- a blood transfusion or blood products containing the virus (these are tested in the UK but not in all other countries);
- sharing infected needles and injecting equipment; and
- contact with unclean needles used in body piercing and tattooing.
What are the advantages of having screening for HIV in pregnancy?
If you are HIV positive and do not know it, there is a high chance (25%, or 1 chance in 4) that your baby will become HIV positive.
If you are found to have HIV, a number of things can be done to lower the chance of you passing it to your baby. You will be offered specialist treatment and care. If you accept the treatment offered, the risk to your baby will be reduced to 1% or less (1 in 100 or less). The treatment may also help to keep you in better health.
What are the disadvantages of having screening for HIV in pregnancy?
There is no good time to find out that you are HIV positive. However, if you find out when you are pregnant, you can have treatment to help stop your baby catching the virus from you.
Should I have the screening test for HIV?
Only you can decide whether to have the test or not. All hospitals in Wales offer all women a screening test for HIV because it is possible to reduce the chance of the baby catching the virus.
What will the screening test result tell me?
Screening for HIV measures antibodies in your blood.
The test result will tell you if you have HIV infection. If the result shows that you do not have an infection, it is important to remember that you can catch HIV when you are pregnant. If you change your sexual partner during the pregnancy, you should use a condom.
If you have caught HIV in the few weeks before the blood sample is taken, your body may not have started producing antibodies and the test will not be able to detect the infection.
If, while you are pregnant, you change your partner or are worried that you might have caught HIV, hepatitis B, syphilis or other diseases which can be passed between people, you can ask your midwife to do another test at any time during your pregnancy. You can also get confidential testing from your nearest sexual health clinic. You can get more information on: www.publichealthwales.org
What is the diagnostic test for HIV?
The screening test for HIV is very accurate. If the screening test shows that you are HIV positive, you will have other blood tests so that the doctor can plan your treatment.
Does having the HIV screening test affect insurance policies?
Insurance companies should not ask if someone applying for insurance has had a test for HIV. They can only ask whether someone has had a positive test result. If you already have a life insurance policy, it will not be affected by taking a HIV test, even if the result is positive, as long as you did not withhold any important facts when you took the policy out.
This information comes from joint guidelines from the British Medical Association and the Association of British Insurers. July 2008. Website: http://www.bma.org.uk/images/MedicalInfoInsurance_tcm41-173470.pdf (Accessed on 22/09/09)
What if I have HIV?
If the test shows you have HIV, you will be able to plan with your midwife or doctor what happens next. You will be offered specialist medical care and treatment to help with the infection. This will help reduce the risk of your baby getting the virus. Treatment will include drug therapy. You may also be advised to have a Caesarean delivery and not to breastfeed. This treatment will not cure you but it will improve your health.
More information
You can get more information about HIV from:
- your midwife, hospital doctor (your obstetrician) or GP; or
- your nearest NHS sexual health clinic - you can phone your local hospital and ask for the sexual health or GUM clinic.
Hepatitis B
What is hepatitis B?
Hepatitis B is a virus that infects the liver. Many people who have hepatitis B do not know they have it. Most adults with hepatitis B make a full recovery, but a small number become 'carriers' of the virus. People who are carriers may develop serious liver disease.
If a pregnant woman has hepatitis B, her baby can be exposed to the hepatitis B virus during the delivery. A baby who catches the virus may have the infection for life and may be at risk of liver disease.
How can hepatitis B be caught?
Hepatitis B can be caught through:
- a mother who is infected passing it to her baby during delivery;
- having unprotected sexual activity (without a condom) with someone who is infected;
- having contact with the body fluids of someone who is infected;
- having contact with unclean needles used in body piercing and tattooing;
- sharing infected needles and injecting equipment;
- blood transfusions and medical procedures carried out abroad; and
- living for a long time in close contact with someone who is infected.
What are the advantages of having screening for hepatitis B in pregnancy?
Testing for hepatitis B is important because if doctors know about the infection before a baby is born, a course of vaccinations started soon after the birth can help stop the baby catching the virus. The vaccinations protect most babies from developing hepatitis B.
If you have hepatitis B, there is a very high chance that your baby will become infected (up to 70% or up to 70 out of a 100 times). If you have the screening test and are positive for hepatitis B, your baby can be vaccinated and the chance of your baby being infected will be less than 5% (that is, five times out of 100).
What are the disadvantages of not having screening for hepatitis B in pregnancy?
There is no good time to find out that you have hepatitis B. However, if you find out when you are pregnant, your baby can be vaccinated to help prevent them from catching the virus from you.
Should I have the screening test for hepatitis B?
Only you can decide to have the test or not. All hospitals in Wales offer all pregnant women a screening test for hepatitis B because the baby can be vaccinated to help stop them catching the virus from you.
What will the screening test result tell me?
Screening for hepatitis B looks for the hepatitis B virus in your blood.
The test result will tell you if you are infected with hepatitis B. If the result shows that you do not have an infection it is important to remember that you can catch hepatitis B when you are pregnant. If you change your sexual partner during the pregnancy, you should use a condom.
If you have caught hepatitis B in the few months before the blood sample is taken, the test will not be able to detect the infection.
If, while you are pregnant, you change your partner or are worried that you might have caught HIV, hepatitis B, syphilis or other diseases which can be passed between people, you can ask your midwife to do another test at any time during your pregnancy. You can also get confidential testing from your nearest sexual health clinic. You can find more information on: www.publichealthwales.org
What is the diagnostic test for hepatitis B?
The screening test for hepatitis B is very accurate. If the screening test shows that you have hepatitis B, you will need other blood tests so the doctor can plan the vaccinations the baby will need.
What if I have hepatitis B?
If you have hepatitis B, your midwife or doctor will talk to you about how it will affect you.
You may also be worried that other people in your family have the infection. They can also be tested and vaccinated if necessary.
Syphilis
What is syphilis?
Syphilis is a serious bacterial infection. Most people who have syphilis are unwell for only a short time at first and they may not be aware they have it. But if syphilis is not treated, it can cause serious problems later in life, including brain damage and heart problems.
How can syphilis be caught?
Syphilis can be caught through:
- a woman who has syphilis passing the infection to her unborn baby during pregnancy; or
- having unprotected sexual activity (without a condom) with an infected person.
What are the advantages of having screening for syphilis in pregnancy?
Treatment with antibiotics in early pregnancy will help you and will usually prevent your baby from catching syphilis. Occasionally, babies may also need antibiotics when they are born. If you have syphilis when you are pregnant, it can lead to a miscarriage or can harm your baby.
What are the disadvantages of screening for syphilis in pregnancy?
There is no good time to find out that you have syphilis. However, if you find out when you are pregnant, you can have treatment to help prevent your baby from developing major problems.
Should I have the screening test for syphilis?
Only you can decide to have the test or not. All hospitals in Wales offer all pregnant women a screening test for syphilis because treatment with antibiotics can help prevent your baby from developing major problems.
What will the screening test result tell me?
Screening for syphilis measures antibodies in your blood.
The test result will tell you if you have the syphilis infection. If the result shows that you do not have an infection, it is important to remember that you can catch syphilis when you are pregnant. If you change your sexual partner during the pregnancy, you should use a condom.
If you have caught syphilis in the few weeks before the blood sample is taken, your body may not have started producing antibodies and the test will not be able to detect the infection.
If, while you are pregnant, you change your partner or are worried that you might have caught HIV, hepatitis B, syphilis or other diseases which can be passed between people, you can ask your midwife to do another test at any time during your pregnancy. You can also get confidential testing from your nearest sexual health clinic. You can find more information on: www.publichealthwales.org
What are the diagnostic tests for syphilis?
The results of the screening test for syphilis are not always easy to understand. Sometimes the result of the screening test will come back positive because you have had syphilis in the past and have been treated, or you have a different and less serious problem. If the screening test is positive, you will be given an appointment with a doctor specialising in these types of diseases. This doctor will ask you questions, including questions about previous infections, to make a diagnosis and decide on the best treatment.
What if I have syphilis?
If you have syphilis, your midwife or doctor will talk to you about how it will affect you. You will probably be given antibiotics and need more blood tests.
More information
You can get more information about syphilis from:
- your midwife, hospital doctor (your obstetrician) or GP; or
- your nearest NHS sexual health clinic - you can phone your local hospital and ask for the sexual health or GUM clinic.
Rubella (German measles)
Screening to see if you are protected against rubella will not protect the baby in this pregnancy.
If you are not protected against rubella (rubella susceptible), you can be offered vaccinations after the pregnancy. This would protect any further pregnancies being affected by rubella.
What is rubella?
Rubella, or German measles, is a common childhood illness. It is a viral infection and spreads easily from one person to another. It is normally a mild illness. Someone with rubella usually has a rash and feels unwell for about a week.
However, if you catch rubella in the first 12 weeks of pregnancy, it can cause serious damage to your baby’s brain, heart, eyes and hearing. This is called congenital rubella syndrome.
How can rubella be caught?
Rubella can be caught through:
- direct contact with nasal or throat fluids of someone who is infected; and,
- breathing in droplets that are sprayed into the air when an infected person sneezes, coughs or talks.
What are the advantages of having screening for rubella susceptibility in pregnancy?
If you are not protected against rubella, you will be offered two immunisations with measles, mumps and rubella vaccine (MMR) after this pregnancy has ended. You need to remember that the screening test is only to find out if you are not protected against rubella. The test does not look for rubella infection and does not show if the baby has been affected by a rubella infection. You should not be offered the vaccination in pregnancy.
Should I have the screening test to see if I am not protected against rubella?
Only you can decide to have the test or not. All hospitals in Wales offer all pregnant women a screening test to see if they are protected against rubella.
Even if you have had the rubella vaccination in the past, it is still important to have the blood test now you are pregnant. About 5% (that is, five out of 100) of people who have been vaccinated are not protected.
What is the diagnostic test to see if you are protected against rubella?
The screening test to see if you are protected against rubella is very accurate and you would usually not need any extra tests.
What if I am not protected against rubella?
If the test shows you are not protected, you will be offered two MMR vaccines to protect you in future pregnancies. The first vaccination should be at the end of this pregnancy, and a second vaccination four weeks later.
Important information
If you get a rash or come into contact with someone who has a rash when you are pregnant, tell your midwife or doctor. You may need to have other blood tests to see if you have caught rubella or another viral infection that causes a rash. |
