The issue of pregnancy and antiviral therapy for chronic hepatitis B (CHB) is a very difficult and challenging issue that we clinicians must face on a daily basis. At present, many domestic and international guidelines for the prevention and treatment of CHB have not addressed this issue in depth and in detail, which is a blind spot and a forbidden area in current medicine. The use of oral anti-hepatitis B drugs during pregnancy requires the guidance of a medical professional and a full discussion with the patient and her family to weigh the pros and cons. 1. Planned pregnancy: (1) If the baseline HBVDNA level is low (HBVDNA <105copies/ml for HBeAg-positive; for HBeAg-negative with no significant vascularization, withhold antiviral therapy and monitor during pregnancy. (2) If the baseline HBVDNA level is high and there is significant liver fibrosis but no cirrhosis, antiviral therapy is recommended first. If the response can be sustained after drug discontinuation, pregnancy can be carried out and monitored during pregnancy and treated as in (1) above; if the response cannot be maintained after drug discontinuation, then treated as in (3) below. (3) If cirrhosis existed before pregnancy, it is recommended to administer antiviral therapy before pregnancy and choose LMV or TDF or LDT, and continue antiviral therapy with one of the above drugs during pregnancy, and monitor throughout pregnancy. A more aggressive recommended regimen was published in September 2010 by the American scholar BzowejNH, in which the authors concluded that pregnant women who are HBsAg positive should be evaluated early in pregnancy and treated immediately with LAM or TDF if there is hepatitis activity or if there is suspicion of cirrhosis. In the absence of the above, HBVDNA should be tested at the end of the second trimester, i.e., 26-28 weeks of gestation, and LAM or TDF treatment should be started if HBVDNA >107copies/ml and closely monitored if HBVDNA <107copies/ml for pregnant women with no history of delivery or a history of delivery but no history of HBV(+) infant delivery; for women with HBV (+) infant birth history, regardless of their HBVDNA levels, need antiviral treatment. 2. Unintended pregnancy: For women who become pregnant unexpectedly during anti-hepatitis B virus treatment, there is no standard treatment plan for the time being, and the treatment is individualized for each case. There are two options: one is to temporarily discontinue the drug, monitor HBVDNA and ALT levels throughout the pregnancy, and then decide whether antiviral therapy according to the specific situation in the third stage of pregnancy, but only for patients with mild hepatitis and less risk of serious rebound or disease progression; the other is to continue antiviral therapy throughout, but should be changed to lamivudine or tenofovir (currently not available in China) or LDT (tenifovir). The other is the whole continuous antiviral treatment, but should be changed to lamivudine or tenofovir (currently not available in China) or LDT (tenifedine). 3. Postpartum management: There are two major problems that will be faced after delivery. One is whether to continue antiviral therapy for the mother after delivery. Discontinuation of nucleoside analog therapy after delivery may lead to rebound of hepatitis, therefore, HBVDNA level should be monitored closely after delivery and the decision to continue oral antiviral therapy should be made on a case-by-case basis. The second question is, can I breastfeed my newborn after delivery? In general, if the mother is not on antiviral therapy and the newborn has received timely active and passive immunoprophylaxis, breastfeeding will not increase the risk of HBV infection in the newborn; if the mother is on antiviral therapy, a cautious decision to breastfeed is needed, as the safety of these drugs for the newborn has not been proven during lactation exposure.