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However, interferon therapy is not pediatrics urgent. The drug is cytotoxic, and it is probably safer to wait until the pregnancy is complete before pediatrics considering therapy. There are subtle indications that the patient has cirrhosis. The spleen is slightly enlarged, there is mild hypersplenism and the liver is inhomogenous on ultrasound. At caesarean section distended veins were noted, consistent with portal hypertension; however, liver function was normal. Pregnancy is unlikely in the face of abnormal liver function. It is important that the patient be followed closely after delivery. She is HBeAg positive, and at risk for further flares pediatrics of acute-on-chronic hepatitis. If any of these flares are prolonged she would once more be a candidate for treatment. Alternatively, she could be going through a seroconversion flare, in which case she would lose HBeAg, and become anti-HBe positive. This is usually accompanied by remission of active hepatitis, which is usually permanent.
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