Screening for infectious diseases in pregnancy
At your first antenatal visit you will be offered and recommended tests for Hepatitis B, Human Immunodeficiency Virus (HIV), and Syphilis. These tests can all be done from one blood sample and are offered to help protect your health and that of your baby.
Although the infections may not make you feel ill, if they are not detected they can cause serious damage to your baby. If we know about them, you can receive special care or medicine to reduce the risk of damage to you or your baby. It is better to have the tests as early as possible, but they can be done at any time during your pregnancy.
For further details on the individual infections included in this screening programme please read Public Health England's leaflet about screening for you and your baby.
'Screening tests for you and your baby' leaflet
Human Immunodeficiency Virus (HIV)
The HIV test is offered and recommended to all pregnant women because you can pass the HIV virus on to your baby while you are pregnant, when you give birth or by breastfeeding. If you have HIV infection you can receive special care and medicine to greatly reduce the chances of your baby becoming infected. The treatment may also help to keep you in better health. HIV is the virus which causes AIDS (Acquired Immune Deficiency Syndrome). The virus gradually weakens the immune system, which makes it difficult to fight off infections.
The most common way of becoming infected with HIV is by having unprotected sex (that is, sex without using a condom) with someone who already has HIV. You can also become infected with HIV if you share needles when injecting drugs, or have a tattoo or body piercing with needles which have not been sterilised. All blood transfusions in the UK are now screened for HIV. The HIV test looks for antibodies to HIV. If the test is negative, it usually means that you are not infected with HIV. However, it can take up to three months for antibodies to develop, so if you think you may have been at risk of catching HIV recently, it is important to discuss this with your midwife. If you are found to be infected with HIV, your doctor can discuss offering a test to your partner and any children you have so that they can receive the right care if they need it.
If you are infected with hepatitis B, your baby is at risk of being infected when you give birth. An infected baby has a high risk of carrying the hepatitis B virus for life. About a quarter of babies who are infected in this way develop serious liver disease in later life. If you are a carrier of hepatitis B, your baby can receive a course of hepatitis B vaccine which begins soon after they are born. It is important that your baby has the full course of vaccines for it to be effective in reducing the baby’s risk of becoming a carrier. At the end of the course of vaccines we will do a blood test on your baby to make sure it has been effective.
Hepatitis B is an infection of the liver caused by a virus. You can have the virus but feel well. Most women who have hepatitis B probably caught it from their own mother at birth. You can also become infected through unprotected sex (that is, having sex without using a condom) with someone who is already infected, by sharing needles when injecting drugs, or by having a tattoo or body piercing with needles which have not been sterilised.
All blood transfusions in the UK are screened for the virus and so it cannot be passed on in this way. But we cannot be so sure if you have had blood transfusions abroad or a medical procedure using unsterilised equipment. Although nine out of ten adults who catch hepatitis B recover fully from the infection, up to one in ten will carry the virus for life. If you are found to have hepatitis B infection, your doctor should offer the test to your partner and any other children you have so that they can be offered a vaccination if it is appropriate. You will also be referred to a doctor who specialises in this condition.
Although syphilis is rare in the UK, testing is recommended during pregnancy because of the serious damage it can do to you and your baby. It can be cured by treatment with antibiotics (usually penicillin), which will also treat any infection in your unborn baby. If you do have syphilis, your baby will also be treated with antibiotics after birth to make sure he or she is not infected. Although most people who have syphilis are only ill for a short time, it can eventually have very severe effects (such as brain damage) if it is not treated. If it is passed to your unborn baby it often results in miscarriage or stillbirth, or the baby being born early and severely ill. Almost all syphilis infections in the UK are caught by having unprotected sex with a person who is infected. If you have syphilis, your partner should also be offered a test.
Receiving you results
Your midwife or obstetrician will give you the results of these tests at your first appointment after booking if the result is negative.
If a test result suggests that you have an infection, you will be invited to an appointment with a specialist midwife who will explain things more clearly and arrange a second blood test to confirm the result.
Making the decision to have or not to have these tests is a personal one that you need to make. You should be reassured that choosing not to have the tests will not affect any of the other care you are given throughout your pregnancy. Having any of these tests does not affect your chance of getting certain insurance or cover provided. It is only if you are actually found to have HIV, syphilis or hepatitis B infection that future insurance cover might be affected.
What if I decide not to have this screening test?
You will be reoffered screening, at every appointment with your midwife. You can also request these tests at any time during your pregnancy.