PGIMS Rohtak Gynaecologist Dr Vani Malhotra bags award for research on Hepatitis B pregnant patients

Rohtak: In recognition of her outstanding research on preventing vertical transmission of hepatitis B in pregnant patients, Dr Vani Malhotra, professor of obstetrics & gynecology, PGIMS, Rohtak, has been awarded Amarinder Nath Dan first prize in Mother child care at the 65th national conference of the Federation of Obstetrics & Gynecology (FOGSI), held recently in Kolkata. 

Because her research yielded accurate results and no such study had ever been conducted in medical history before, her work was rewarded with the award.

In fact, her work has been praised by many medical professionals in the field. Commenting on this, the PGIMS administration said it is one of the rare research worldwide to date and the research was done over the last five years at the institute.

Dr Vani did her MD in the years 2000-2003. She has been working as Faculty at PGIMS, Rohtak, since 2006. She is a Member of the Undergraduate and Postgraduate board of studies at PGIMS, Rohtak.

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According to her research findings, hepatitis B virus or antiviral treatments had no adverse effects on pregnant women or newborns.

HBV infection is a global problem with nearly 350 million chronic carriers and over 50% of these carriers are believed to have acquired their infection vertically from their mothers, i.e. through mother-to-child transmission (MTCT).

The study's aim was to prevent MTCT of HBV by administrating antiviral drugs, as per indication to Hepatitis B-positive pregnant mothers and mandatory HBV Vaccine and Hepatitis B immunoglobulin (HBIG) to newborns and to evaluate vertical transmission to neonates.

Around 460 Hepatitis B-positive, pregnant patients were enrolled in the study. Out of the 120 patients with high viral load and/or HBsAg positivity were started on antiviral treatment from 28 weeks of pregnancy.

All the newborns were given zero doses of the HBV vaccine and HBIG (0.5 ml) within a few hours of birth and the next three doses of HBV at 6,10 &14 weeks of life.

All the newborns were followed till 12 months of age and HBsAg and HBV DNA quantitative was done at one year of age.

As per guidelines, vertical transmission is confirmed if a child of a hepatitis B-positive mother, at one year of age is detected to be HbsAg or HBV DNA positive.

To date, 150 newborns have attained one year of age, and all of them have been found to be HbsAg negative, meaning by zero percent vertical transmission.

Out of these 150, 35 pregnant mothers were on antiviral treatment. All newborns were breastfed and 20% were delivered through caesarean section, the rate which is comparable to HbsAg negative mothers.

There were no detrimental effects of hepatitis B virus or antiviral treatment on both pregnant females as well as newborns.

“Majority of these pregnant patients belonged to rural areas, were in 20-30 yrs of age group and predominantly delivered in government hospitals. The initial results of this research are very encouraging and stress the need of taking the above steps in all hepatitis B pregnant patients for preventing vertical transmission, so as to decrease the total burden of this deadly disease,” Dr Vani told TOI.

“This research reaffirms continuing with the practice of breastfeeding the newborn and no indication of performing elective caesarean section solely for decreasing vertical transmission of Hepatitis B. It proves that antiviral treatment is safe for both mother and newborn,” she added.

The study clearly highlights the success associated with timely intervention at different stages of pregnancy in HbsAg-positive mothers can lead to complete prevention of vertical transmission.

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