The level of hepatitis B virus carried by a mother with triple III is high. If no blocking measures are taken, it is easy to transmit the hepatitis B virus to the little one. Because the immune system of newborns is not yet sound, once the virus enters the newborn’s body, it can easily lurk. This is what we usually call mother-to-child transmission. The common types of mother-to-child transmission are intrauterine transmission and transmission during delivery: I. Intrauterine transmission: The fertilized egg develops into an embryo and then a fetus in the uterus, and the nutrients from the mother’s uterus pass through the walls of the microvessels and enter into the microvessels of the fetus’s placenta. 2 layers of microvessels allow the dissolved nutrients to permeate, but they can block the passage of viral particles, so the transmission of Hepatitis B Virus to mother-to-child in the uterus seldom occurs. However, if a pregnant woman falls, jumps or bumps violently, the placenta is slightly detached, and the leaking maternal blood enters the fetal blood circulation, then mother-to-child transmission in utero can occur. Second, transmission during labor and delivery: the newborn has a lot of maternal blood contamination during labor and delivery. Hepatitis B virus in the blood can easily enter the uncle’s body through tiny wounds in the newborn’s skin. This is also the most important way of mother-to-child transmission, accounting for about 95%. It’s worth remembering: human sperm and eggs do not contain the hepatitis B virus and cannot be transmitted genetically. How to Prevent Intrauterine Transmission: Intrauterine transmission is about 5%, which is rare but the most difficult to prevent, mainly due to movements that cause the placenta to slightly detach and leakage of maternal blood into the fetal circulation. Pregnant women should, of course, be active and should do some smooth movements; but don’t jump, don’t fall, and don’t ride in the back seat of a bus, which may reduce some intrauterine transmission. At 32 weeks (8 months) of pregnancy, if the check virus level is high, it must also be lowered. Some hospitals in China and abroad give patients additional tibivudine at 32 weeks (8 months) of gestation until delivery, and most of them are able to reduce the virus from 7 times to 3 times without any adverse effects. Tibivudine is a new hepatitis B antiviral drug that was only released in 2007 as a class B drug in pregnancy (no harm to the fetus has been seen in animal studies). The current antiviral drug with the lowest fetal impact on pregnancy is Tebivudine, the only nucleoside analog currently in pregnancy class B. Pregnancy grade A is animal experiments and clinical observation did not find damage to the fetus. grade B animal experiments confirmed that there is no harm to the embryo, but clinical studies failed to confirm or no clinical verification data. Because of the lack of large-scale clinical data in China, this treatment option is for personal reference only. Some experts had recommended that pregnant women be injected with 200 units of hepatitis B immunoglobulin every month in the second trimester of pregnancy. However, in the past two years, this treatment program has been considered ineffective. Because 200 units of hepatitis B immunoglobulin is a drop in the ocean of the hepatitis B virus in a pregnant woman with triple III infection, the Hepatitis B Guidelines do not recommend this approach. How to prevent transmission at delivery: To prevent transmission at delivery, a combination of hepatitis B vaccine and hepatitis B immunoglobulin must be administered to the newborn. Hepatitis B Vaccine and Hepatitis B Immune Globulin: 1. Hepatitis B Vaccine: 20 μg is needed each time and is routinely given within 24 hours, once at 1 month and once at 6 months; it is best to add an additional injection at the 2nd month. Why is this important? The mother’s virus contaminates the newborn during labor, and it takes about 2 months to establish the incubation period for infection. Infants need to repeat the vaccine in order to gradually produce enough antibodies in their bodies, so the earlier the vaccine is started, the better; adding 1 injection at 2 months has a reinforcing effect. China’s hepatitis B vaccine dose is insufficient, more than 20% of the newborns of “triple positive” mothers failed to prevent, so the assistance of hepatitis B immunoglobulin is also needed. 2.Hepatitis B immunoglobulin: It takes 2~3 months for infants injected with hepatitis B vaccine to produce a small amount of antibody, in order to obtain early protection, it is also necessary to inject hepatitis B immunoglobulin within 24 hours of birth. Antibodies appear in the serum after the injection is absorbed, and protection is achieved. Hepatitis B immunoglobulin is given in a dose of 200 units and must be injected on a different side of the buttock than the vaccine so that the vaccine (antigen) is not locally neutralized with the globulin (antibody). The combination of hepatitis B vaccine and hepatitis B immunoglobulin protects more than 90% of newborns of “triple positive” mothers. It is important to note that some mothers think that having a cesarean section reduces the rate of mother-to-child transmission, but some studies have shown that cesarean sections have the same chance of transmission as natural births.