The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e2 

Hepatitis C Screening in Pregnancy: A Single Center 
Quality Improvement Experience 

Amna Iqbal1*, Rand Elsharaiha, Jordan Burlen, Mona Hassan2 

1Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: amna.iqbal@utoledo.edu

Published: 05 May 2023 

Background: Hepatitis C infection is a preventable but serious illness with more than half the patients 
developing chronic infection if infected. According to CDC, an estimated 57,500 acute Hepatitis C 
occurred in United States in 2019. National data revealed increase in reported cases of HCV infection 
every year from 2009 to 2017. Among these patients, highest rates of incidence in people aged 20-39 
years. CDC recommends Hepatitis C screening for everyone at least once in their lifetime and for all 
pregnant women during each pregnancy regardless of risk factors. We conducted a quality improvement 
project in our hospital regarding Hepatitis C screening among pregnant women. Our objective was to 
assess compliance with CDC guideline recommendation regarding Hepatitis C screening in pregnant 
women and suggest ways to improve it. 

Methods: We gathered data of all the pregnant women who presented to the hospital for delivery from 
September 2020 to May 2021 which were a total of 2735 patients, among these 63 patients were 
screened for Hepatitis C. We reached out to all our obstetrics and gynecology providers through emails 
prompting them to screen patients for Hepatitis C during their pregnancy episode. We also educated 
patients on importance of Hepatitis C screening and effects of acute HCV infection on both child and 
mother encouraging them to ask providers for screening test if they are not offered one. Printed handouts 
regarding Hepatitis C screening were distributed among the patients. Then we ran another data analysis 
report in Epic for all pregnant patients June 2021 to March 2022 which showed 3161 patients presented 
to hospital for delivery and among them 121 were screened for Hepatitis C. 

Results: A chi-square analysis was performed which showed chi-square statistic (x2) 11.271 with a p 
value of 0.001 indicating significant results. Overall, 65% increase in screening for Hepatitis C among 
pregnant women presenting to the hospital was observed after implementing Hepatitis C screening 
protocol. 

https://dx.doi.org/10.46570/utjms.vol11-2023-698 

https://dx.doi.org/10.46570/utjms.vol11-2023-698
mailto:amna.iqbal@utoledo.edu


https://dx.doi.org/10.46570/utjms.vol11-2023-698 UTJMS 11(1):e1-e2 

https://dx.doi.org/10.46570/utjms.vol11-2023-698 2 ©2023 UTJMS 

Conclusion: Hepatitis C screening is recommended in all pregnant women during their pregnancy 
episode. We requested our Epic IT team to introduce an EPIC Hard Stop protocol for Hepatitis C when 
pregnant women present for their initial visit and recommended Hepatitis C screening to be made a part 
of Obstretical triage order panel. We also encouraged all providers to refer all Hepatitis C positive 
patients to GI to establish care for Hepatitis C treatment. 

https://dx.doi.org/10.46570/utjms.vol11-2023-698
https://dx.doi.org/10.46570/utjms.vol11-2023-698