Autoimmune hepatitis during pregnancy: Optimal management for delivering at term

Autoimmune hepatitis (AIH) is a chronic inflammatory disease characterized by progressive hepatocellular inflammation not related to alcohol consumption, viral infection, exposure to hepatotoxic drugs, or genetic liver disorders. AIH is associated with a high rate of miscarriage, stillbirth, and premature delivery. This study aimed to discuss the optimal management of AIH during pregnancy in order to maintain the pregnancy up to term. We also determined whether pregnancy influences the flare-up of AIH or vice versa and what the best treatment for AIH during pregnancy is. The case illustration is a 32-year-old pregnant woman diagnosed with AIH delivered a healthy baby vaginally at 38 weeks of gestational age. The treatment strategy for AIH is to obtain complete remission and avoid further progression of the disease. The European Association for the Study of the Liver (EASL) states that the first-line therapy for AIH is prednisone/prednisolone, followed by the addition of azathioprine after 2 weeks. It can be concluded that optimal management of AIH during pregnancy is required in order to maintain the pregnancy up to term.