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Texas Perinatal Hepatitis B Prevention Program Manual45M other Summary Report for Perinatal Hepatitis B Prevention Infectious Disease Intervention and Control Branch Texas Department of Health State
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To fill out the Texas Perinatal Hepatitis B form, follow these steps:
02
Begin by filling out the top section of the form, including the patient's name, date of birth, and social security number.
03
Next, provide information about the patient's mother, including her name, hepatitis B surface antigen (HBsAg) status, and whether she received hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine.
04
Fill out the section regarding the perinatal period, including the date of birth, birth weight, and any complications during delivery.
05
Indicate whether the infant received HBIG and/or hepatitis B vaccine within 12 hours of birth.
06
Provide information about the infant's hepatitis B surface antigen (HBsAg) status, as well as any subsequent hepatitis B vaccination dates and results.
07
Finally, sign and date the form to certify its accuracy and completeness.

Who needs texas perinatal hepatitis b?

01
Texas Perinatal Hepatitis B form is needed for infants born to mothers who are positive for hepatitis B surface antigen (HBsAg), and are at risk of perinatal transmission of hepatitis B virus.
02
Additionally, infants who have received hepatitis B vaccine within 12 hours of birth or have an unknown hepatitis B surface antigen (HBsAg) status should also be included in the Texas Perinatal Hepatitis B program.
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Texas perinatal hepatitis B refers to the state program designed to prevent the transmission of hepatitis B from an infected mother to her newborn during childbirth through screening and vaccination.
Healthcare providers who care for pregnant women are required to file Texas perinatal hepatitis B after testing pregnant patients for hepatitis B.
To fill out the Texas perinatal hepatitis B form, providers must complete the patient information, document the hepatitis B test results, and include information on vaccinations for the newborn.
The purpose of Texas perinatal hepatitis B is to identify and manage hepatitis B in pregnant women to protect newborns from infection and to provide them with necessary vaccinations.
The report must include the mother's hepatitis B status, test results, vaccination information for the infant, and details about any antiviral treatment administered during pregnancy.
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