It is unwise to use only enzyme-lowering drugs for the first outbreak of hepatitis. After enzyme reduction, the disease is only temporarily alleviated, but usually the medication must be stopped before preparing for pregnancy, and most of them will rebound after stopping. There is no substitute for antiviral therapy after the onset of hepatitis. Long-acting interferon is the patent of young girls, from waiting for the time of treatment to be able to prepare for pregnancy must be expected to 2 years, may not be effective time wasted. The safest is tenofovir, most of the medication for 3 months to stabilize the normal transaminases can prepare for pregnancy, to the end of pregnancy has long been the virus turned negative, the pregnant woman is healthy, blocked intrauterine transmission, the newborn only need to inject conventional vaccines, natural childbirth, can breastfeeding. It is expected that the domestic drug will be available next year, and the cost of the drug will not exceed that of domestic entecavir. More than a thousand young patients have been examined in the last 2 years, and no abnormal kidney function has been detected, and the drug is never resistant to long-term administration. Patients who are taking entecavir can prepare for pregnancy only 3 months after switching to tenofovir. Those who have difficulty conceiving and need to be regulated with obstetrical and gynecological hormones can use tenofovir at the same time. Tenofovir can also be taken if in vitro fertilization is required. Recently, we examined more than 20 mothers with “major triplet”, virus ≥6 times copies/ml, who were not aware of preventive medication, and 3 newborns within 24 hours had hepatitis B virus detected in their blood, and the infection rate of intrauterine and perinatal newborns was >10%. “Major triple-positive”, pregnant carriers with viruses ≥6th powercopies/ml, from 28 weeks when they started taking lamivudine/tibivudine until they stopped taking it at delivery, several of the examined viruses were able to reduce by 2th powercopies/ml. I have been instructing numerous pregnant carriers in my clinic for more than 10 years and no neonatal infections have been found so far. Do not use tenofovir, as long as more than 12 weeks, see later for reasons. Myth 1: Pregnant women at the end of pregnancy are injected with hepatitis B immunoglobulin to prevent transmission, a method that has been published in a domestic English journal and has been widely used in China. Please think about this: a newborn baby with no virus in the blood yet, weighing a little more than 3 kg, 1 shot of globulin (that is, surface antibody) is effective for prevention immediately after injection; a pregnant woman of 60-70 kg, whose blood is 7% of her body weight, has millions (6th power) to hundreds of millions (8th power) of copies/ml of virus, will 100 units of globulin be useful? Myth 2: Caesarean section reduces the rate of mother-to-child transmission than natural conduction, however, all newborns are carried out from the mother’s blood. Not to see red trace serum are infectious, cesarean section and natural normal delivery will have a difference? Third, hepatitis after delivery About 25% of the decades of chronic carriage of hepatitis B virus will occur chronic hepatitis. Pregnancy does not significantly increase the burden on the liver, and the incidence during this period is also within the range of 25%, with more than 40% developing within 6 months after delivery. Why? With paternal sperm and maternal egg, half of the fetus’ genes come from the father, which corresponds to a heterozygous transplant in the womb. From a young animal is a male and female hybrid, evolving over millions of generations to avoid graft rejection. How is this possible? Natural suppression of immunity during pregnancy and the conversion of estrogen to progesterone protects the fetus from miscarriage. The use of overly potent tenofovir, or taking the drug for too long, the possibility of rebound after stopping the drug is higher, which will increase the incidence of hepatitis after delivery. The controversy about breast milk Please refer to the earlier blog posts “Can a mother with “Tai San Yang” breastfeed? The fetus is born from the vacuum of the womb into the air. Water, human body, clothing everywhere in the big world of microorganisms, only breast milk can provide a variety of antibodies that babies can accept, and breast milk is extremely important for the health of small children. That’s why the World Health Organization highly recommends breastfeeding.