What we offer
At your booking visit all women are offered blood tests to screen for common conditions that could affect the mother and baby. These blood tests include an infection screen for HIV, Hepatitis B and Syphilis. We screen for these infections so that if they are detected in early pregnancy, we can prevent your baby catching these infections.
HIV is caused by a virus called retrovirus that prevents the body’s immune system from working properly and makes it hard to fight off infections. If you are HIV positive the virus can be passed to your baby through the placenta while you are pregnant, during the birth and through your breast milk. The care you will receive aims to prevent the risk of passing HIV on to your baby.
You will be seen by midwife Kay Francis for booking and obstetrician Miss Govind for pregnancy care in the Thursday morning high risk obstetric clinic throughout your pregnancy. We aim to control your HIV infection to reduce the risk of transmission to the baby and keep you well. You will see Dr Chris Wood for this who will discuss and offer anti-retroviral treatment. You will have individualized care through your pregnancy and a birth-plan will be made by midwife Kay Francis based on your HIV control. Many women with good control achieve safe vaginal delivery of their baby. After your baby is born, the new born will be followed up by pediatrician Dr Daniels who will provide anti-retroviral treatment to reduce the baby’s chance of becoming HIV positive even further. We advise against breastfeeding as this can transmit the virus to the baby but this can be discussed with your HIV team during the course of the pregnancy.
Hepatitis B (HBV) is a viral infection affects your liver though many people are not aware they have the infection and have no symptoms. If you are found to have Hepatitis B in pregnancy you will have blood tests to check your liver function and assess the type of infection in more detail. You will be seen by the specialist liver team under the care of Dr Andrew Millar, obstetrician Miss Govind and midwife Kay Francis.
The antenatal hepatitis clinic runs on a monthly basis to review all pregnant woman who have liver problems, particularly those with hepatitis B. With careful planning and treatment we expect to fully prevent hepatitis B transmission to babies. This is by vaccination, monitoring, and sometimes medication for the pregnant mother. The Hepatology team works closely with the midwives and obstetricians to ensure we look after all expectant mothers with liver problems.
All babies are now offered vaccination against HBV in the first few months, though the first injection is given at birth if the mother has HBV. Some babies are also given immunoglobulin antibody against HBV at the same time. In mothers with a high level of the virus, the mother is offered treatment with medication to reduce the level of virus as this further reduces the chance of the baby being infected with HBV. The team will provide support and counselling for you and advise testing your partner and children. Importantly arrangements will be made for ongoing care in the Hepatology department for all mothers with hepatitis B.
We do not routinely test for Hepatitis C in pregnancy, but all those considered at risk, including those with HIV or HBV, will be offered this test. It is uncommon for Hepatitis C to be passed from mother to baby but all those with hepatitis C will be seen in the antenatal clinic to be offered counselling and plan treatment of the condition. Hepatitis C can now be easily treated with tablets for 2-3 months and this is offered to the mother after the baby is born.
Syphilis increases the risk of miscarriage, preterm birth, stillbirth and congenital syphilis. A baby with congenital syphilis, if left untreated can develop physical and neurological impairments affecting the child’s bones, teeth, vision and hearing. If your screening blood tests are positive for syphilis then you will be seen and counselled by our midwife Kay Francis. Sometimes the result are false positive and further tests may be needed. You will be seen by Dr Loke for further management. Syphilis is treatable with antibiotics, but should you have syphilis in pregnancy then your baby may need extra scans for close monitoring and Dr Loke will suggest screening for other sexually transmitted infections. If you are diagnosed with syphilis during your pregnancy and then your baby will be followed up by the paediatric team.
Meet our team
- Consultant obstetrician - Miss Abha Govind
- HIV physician – Dr Christopher Wood
- Hepatologists – Dr Andrew Millar, Dr Thendral Mangala
- Sexual heath consultant - Dr Wai Ching Loke
- HIV pediatrician – Dr Justin Daniels
- Specialist midwife – Mrs Kay Francis
- HIV paediatric clinical nurse specialist - Yolette Lees
How you get referred
If you are known to have any of these infections or if they are detected on your screening blood tests then you will be referred to the High-risk obstetric clinic by your midwife.