Mothers with major triple-positive carry high levels of the hepatitis B virus. If blocking measures are not taken, it is easy to transmit the hepatitis B virus to the little one. Because the newborn’s immune system is not yet complete, the virus can easily lurk once it enters the newborn’s body. This is what we usually call mother-to-child transmission. The common types of mother-to-child transmission are in utero transmission and transmission during delivery. What is in utero transmission. The fertilized egg develops into an embryo and then into a fetus in the uterus, and the uterine surface of the mother passes nutrients through the microvascular wall into the placental microvasculature of the fetus. 2 layers of microvasculature allow the dissolved nutrients to pass through, but prevent the virus particles from passing through, so mother-to-child transmission of hepatitis B virus rarely occurs in the uterus. However, mother-to-child transmission in utero can occur if a pregnant woman falls, jumps or has a violent bump and the placenta is slightly abducted and leaking maternal blood enters the fetal blood circulation. What is transmission during delivery. The newborn has a large amount of maternal blood contamination during delivery. The hepatitis B virus in the blood can easily enter the body through tiny wounds in the newborn’s skin. This is the most predominant mode of mother-to-child transmission, accounting for about 95 percent. It’s worth remembering that human sperm and eggs do not contain the hepatitis B virus and are not genetically transmitted. How to prevent in utero transmission. Intrauterine transmission is about 5%, which is rare but the most difficult to prevent, mainly due to some movements that cause a slight abruption of the placenta and leakage of maternal blood into the fetal blood circulation. Pregnant women should certainly be active and should do some smooth exercises; but don’t jump, don’t fall, and don’t sit in the back seat of the bus, which may reduce some intrauterine transmission Some experts used to recommend giving pregnant women 200 units of hepatitis B immunoglobulin per month in the second trimester of pregnancy. However, in the last two years, this treatment regimen has been deemed ineffective. This is because 200 units of hepatitis B immunoglobulin is undoubtedly a drop in the ocean for the hepatitis B virus in a pregnant woman with major triplets. How to prevent transmission during childbirth. To interrupt transmission during delivery, a combination of hepatitis B vaccine and hepatitis B immune globulin must be given to the newborn. Hepatitis B vaccine: 20 μg is needed each time, and the routine injections are one within 24 hours, one at 1 month and one at 6 months; preferably, one additional injection is given at the second month. Why is this necessary? The mother’s virus is contaminating the newborn during delivery, and the incubation period for establishing infection takes about 2 months. Infants need repeated injections of the vaccine for their bodies to gradually produce sufficient antibodies, so the earlier the injections are started, the better; an additional injection at 2 months has a booster effect. Hepatitis B immunoglobulin: It takes 2 to 3 months for infants who have received the hepatitis B vaccine to develop a small amount of antibodies, so for early protection, hepatitis B immunoglobulin must also be injected within 24 hours of birth. Antibodies can appear in the serum after the injection is absorbed, and there is protection. The dose of hepatitis B immunoglobulin needs to be 200 units and must be injected on a different side of the hip from the vaccine so that the vaccine (antigen) will not be neutralized locally with the globulin (antibody). The combination of hepatitis B vaccine and hepatitis B immune globulin provides more than 90% protection for newborns of mothers with “major triplets”. It is important to note that some mothers think that a cesarean section will reduce the rate of mother-to-child transmission, but some studies have shown that a cesarean section has the same chance of transmission as a natural birth.