Test for hepatitis C at first antenatal visit-New pregnancy care guidelines

The new Australian clinical practice guidelines on pregnancy care recommend routine testing for hepatitis C at first antenatal visit. The guidelines have appeared in the Medical Journal of Australia.

The guidelines shall provide reliable and standardised guidance for health professionals providing antenatal care in Australia including midwives, obstetricians, general practitioners. It shall help ensure that women in Australia are provided with consistent, high quality,evidence-based maternity care.

They were originally released as the Clinical Practice Guidelines: Antenatal Care in two separate editions (modules 1 and 2) in 2012 and 2014. These modules have now been combined and updated to form a single set of consolidated guidelines that were publicly released in February 2018 as the Clinical Practice Guidelines: Pregnancy Care. Eleven topics have been updated and new guidance on substance use in pregnancy has been added.

Main recommendations: The updated guidelines include the following key changes to practice:

• Recommend routine testing for hepatitis C at the first antenatal visit;


• Recommend against routine testing for vitamin D status in the absence of a specific indication;


• Recommend discussing weight change, diet and physical activity with all pregnant women; and


• Recommend offering pregnant women the opportunity to be weighed at every antenatal visit and encouraging women to self-monitor weight gain.

There will be certain changes in management as a result of the guidelines eventually benefitting the pregnant ladies. They are as follows-

1. The guidelines will enable pregnant women diagnosed with hepatitis C to be identified and thus avoid invasive procedures that increase the risk of mother-to-baby transmission.


2. Women can be treated postpartum, reducing the risk of liver disease and removing the risk of perinatal infection for subsequent pregnancies.


3. Routine testing of all pregnant women for vitamin D status and subsequent vitamin D supplementation is not supported by evidence and should cease as the benefits and harms of vitamin D supplementation remain unclear.


4. The recommendation for health professionals to provide advice to pregnant women about weight, diet and physical activity, and the opportunity to be weighed will help women to make changes leading to better health outcomes for themselves and their babies.

The Guidelines provide a reliable and standard reference for health professionals providing antenatal care. By providing a summary of the currently available evidence on many aspects of antenatal care, they aim to promote consistency of care and improve the experience and outcomes of pregnancy care for all families.

For full guideline log on to: doi: 10.5694/mja18.00286