A patient with 37 weeks of gestation, came to hospital without antenatal check-up and presented with onset of labor. On examination, the mother is hep B positive, what management should be given to neonate?
**Core Concept**
The management of a neonate born to a hepatitis B e antigen (HBeAg)-positive mother involves administering hepatitis B immunoglobulin (HBIG) and the first dose of hepatitis B vaccine within 12 hours of birth to prevent vertical transmission of the virus.
**Why the Correct Answer is Right**
The hepatitis B virus (HBV) can be transmitted from an infected mother to her neonate during birth, leading to chronic infection and potentially severe liver disease. The administration of HBIG and the first dose of hepatitis B vaccine within 12 hours of birth has been shown to be highly effective in preventing this transmission. HBIG provides immediate, short-term protection against HBV infection, while the hepatitis B vaccine stimulates long-term immunity.
**Why Each Wrong Option is Incorrect**
**Option A:** Administering the hepatitis B vaccine alone is not sufficient to prevent vertical transmission, as it does not provide immediate protection against the virus.
**Option B:** Delaying the administration of HBIG and the first dose of hepatitis B vaccine beyond 12 hours of birth significantly reduces their effectiveness in preventing vertical transmission.
**Option C:** Not administering any prophylaxis to the neonate increases the risk of vertical transmission and chronic HBV infection.
**Clinical Pearl / High-Yield Fact**
Neonates born to HBeAg-positive mothers require urgent administration of HBIG and the first dose of hepatitis B vaccine within 12 hours of birth to prevent vertical transmission of HBV.
**Correct Answer: C. Not administering any prophylaxis to the neonate increases the risk of vertical transmission and chronic HBV infection.**