Two years ago, I consulted with a 27-year-old pregnant woman who was 28 weeks pregnant and had severe hepatitis in pregnancy. 7 times! I had also participated in a medical dispute evaluation of a young mother who was also a chronic “carrier” of hepatitis B. Her daughter was found to be “major triple positive” when she was less than one year old and sued the hospital for not injecting her child with hepatitis B immunoglobulin at birth. Although the mother won her case, her daughter did not “win” because, like her mother, chronic hepatitis B virus infection has become an irrevocable fact. In addition, there is a more than 5% chance that her daughter’s hepatitis B infection occurred in utero, and the doctor simply “lost” the hepatitis B immunoglobulin by not administering it as usual. These two real cases directly tell us two things: first, women with hepatitis B virus are at risk of liver disease after pregnancy, and the most serious cases can be life-threatening; second, women with a high viral load in their bodies are likely to have their fetuses infected with hepatitis B virus in utero at a rate of more than 5%, and even if the newborns are injected with hepatitis B vaccine and hepatitis B high-value immunoglobulin respectively in time for birth, the infection cannot be completely The rate of infection in utero is over 5%. It has long been a misconception among the general public that pregnancy is risk-free as long as liver function is normal. After pregnancy, both the mother and the fetus in the womb need to consume a lot of nutrition and other metabolism is also very strong, the workload of the liver will be greatly increased, even without the basis of hepatitis B virus infection, pregnant women will often face the embarrassing situation of not being able to make ends meet, not to mention the large amount of virus replication in the body? In fact, in women with chronic hepatitis B virus infection, a normal transaminase (so-called normal liver function) does not mean that there is no damage to the liver, let alone that the liver can bear the burden of pregnancy. In view of the above, women of childbearing age are especially reminded that when preparing for pregnancy, not only should the common pre-conception preparations such as physical and mental harmony, work adjustment, balanced nutrition, healthy diet, reasonable work and rest, and atmosphere creation be done adequately and in place, but also a comprehensive pre-conception physical examination should be done especially, and among the many examination items, indicators of some infectious diseases, including hepatitis B, must be taken into consideration, please do not put the national Please do not confuse the national ban on routine testing for hepatitis B virus indicators in premarital, school entry or job recruitment physical examinations with independent testing for hepatitis B virus before marriage and pregnancy, etc. The national decree is based on anti-hepatitis B discrimination, while your independent testing is a responsible act to protect yourself and your future child. Once you find a positive blood test for the hepatitis B virus gene, it is important to consult an infectious disease physician without delay and to conduct further in-depth tests. Be sure to ask your doctor to perform an assessment of the tolerance level of liver function in relation to the risk of pregnancy, the status of viral replication and the risk of intrauterine viral infection, so that you can determine the best time to become pregnant, confirm the need and how to block the virus, and ensure that your liver can withstand the burden of the entire pregnancy. People with high levels of hepatitis B virus replication have normal and abnormal aminotransferases, respectively. For those with abnormal transaminases, many people try to lower the enzymes through liver protection and get pregnant after the transaminases are normal. Firstly, hepatoprotective and enzyme-lowering drugs also have adverse effects on the embryo; secondly, most women of childbearing age are in the immune activation stage of hepatitis B, and their liver cannot be preserved; thirdly, even if it is preserved for a while, liver damage may occur again at any stage after pregnancy; fourthly, the risk of intrauterine transmission of hepatitis B is always present in those with high viral replication. Therefore, the correct approach should be antiviral treatment. When the virus is suppressed, liver damage will naturally stop; when the amount of virus decreases, the risk of infecting the fetus will naturally decrease. As to whether women with normal transaminases need antiviral therapy, there is a positive attitude, but the timing of antiviral therapy differs from country to country or from expert to expert. The author prefers to go through the whole process of antiviral treatment and advocates conceiving after the virus has reached an unpredictable level because one cannot afford to gamble on the probability of an infection that has already occurred in utero and for which postpartum blockade is ineffective. Repeat the reminder: even if the child is vaccinated with hepatitis B vaccine and hepatitis B immunoglobulin as required at the time of delivery and afterwards, if the viral DNA in the blood exceeds 6 times 10, the probability of intrauterine infection is greater than 5%! “If you are prepared, you will have no regrets”. Women of childbearing age who are “carrying” the hepatitis B virus must keep these two phrases in mind before preparing for pregnancy.