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A case-based session updated delegates latest advances in the management of liver disease during pregnancy, covering the latest advances in the field.

In a case-based session designed to reflect the everyday challenges faced by doctors managing liver disease during pregnancy, the audience was updated on the very latest advances across the liver disease spectrum. Each case was punctuated with the opportunity for the audience to share insights and ask questions of the panel of experts. This truly engaging session incorporated learnings that are directly transferable to routine practice.

Key among these were the need to initiate family planning discussions early in women of childbearing age with AIH and to aim for minimal adjustment of standard immunosuppression during pregnancy to minimize the risk of adverse birth outcomes and the risk of disease flare ups. Pre-pregnancy counselling and assessment of portal hypertension is also critical in the increasing number of women with liver cirrhosis wanting to get pregnant. In this patient population risk scores are valuable to inform management and to devise a delivery plan. The latest research into the use of ursodeoxycholic acid in intrahepatic cholestasis as well as high viral load HBV in the context of pregnancy was also discussed. Given the linear association between high maternal HBV DNA levels and risk of mother-to-child transmission (MTCT), use of tenofovir disoproxil fumarate in the third trimester should be considered mandatory in pregnant women with HBV DNA levels >200,000 IU. Additionally, it was highlighted that amniocentesis should be avoided because of the increased risk of MTCT.

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