Liver injury associated with drug intake during pregnancy

Table 1 Data available from case reports regarding drug-induced liver injury in pregnant women

Suspect drug	Pathological finding(s)	Outcome in mother	Outcome in child
Azithromycin[78]	Intrahepatic cholestasis	Recovery without sequelae	Birth by caesarean section
Chlorpromazine	Severe reduction in the number of bile ducts; marked cholestasis and pseudoxanthomatous transformation of ductular epithelia and hepatocytes in the region of the limiting plate; progressed to cirrhosis[85]; Ductopenia, long-standing cholestasis with pseudoxanthomatous transformation of hepatocytes and ductular epithelia[84]	Prolonged liver disease culminating in vanishing bile duct syndrome and cirrhosis[85]; Gradual resolution with non-active periportal and septal fibrosis[84]	Premature birth by cesarean section[84,85]
Combination antiretroviral therapy	Fulminant hepatitis[105]	Recovery without sequelae[70,105]; death[105]	Nonreassuring fetal testing; improved following drug withdrawal; normal delivery[70]
Human chorionic gonadotropin and follicle stimulating hormone for in vitro fertilization[87]	Cholestasis	Recovery without sequelae	Premature birth by cesarean section
Methyldopa	Cytolytic hepatitis and cholestasis, toxic hepatitis[106]; hepatitis[73,74,107,108]	Improved following drug withdrawal[72-74]	-
Nitrofurantoin[109]	Toxic liver damage	Recovery without sequelae	Normal
Paracetamol	Acute fatty liver of pregnancy and toxin-induced injury[43]; fulminant hepatitis[45]	Liver transplantation[43,45]	Fetal death[43]; intrauterine fetal demise with extensive pericerebral and intraventricular hemorrhage with extensive periventricular leukomalacia[45]; intracranial hemorrhage, fetal hepatotoxicity[110]; preterm birth[111]
Propylthiouracil	Liver necrosis[50,53,54,112]; widened portal triads, and lymphoplasmocytic infiltrate[50]; hepatitis[52]; portal hepatitis[112]; acute liver failure[55]	Liver transplantation[53,55]; recovered[52,54]; death[50]	Miscarriage[50,54]; Antenatal ischemic encephalopathy, delayed developmental milestones[53]; normal[52,55]; caesarian delivery[112]
Tetracycline[83]	Fatty liver	Death	-