Drug-induced liver injury in pregnancy

Tuberculosis in pregnancy

“…This regimen will cure 90% of cases with good drug compliance and improve maternal and perinatal outcomes. Supplementation of pyridoxine and vitamin K maybe necessary, as INH may increase maternal hepatotoxicity (1%) requiring treatment with n-acetyl cysteine, ursodiol, vitamin K, and even liver transplant [ 74 , 75 ]; and peripheral neuropathy, as RIF in the last few weeks of pregnancy can cause maternal and neonatal hypoprothrombinaemia ( Table 1 ). The effect of PZA on the fetus is unavailable, thus although it is recommended by the WHO as part of the standard regime, it is not endorsed by the CDC except it is safe for breastfeeding.…”

Drug‐Induced Liver Injury: A Mexican View

“…There is no evidence that pregnancy increases the susceptibility to DILI. Common causes of DILI in pregnant women are antihypertensive agents, such as methyldopa and hydralazine, and antimicrobials, including antiretroviral agents 11 …”

“…Common causes of DILI in pregnant women are antihypertensive agents, such as methyldopa and hydralazine, and antimicrobials, including antiretroviral agents. 11 The use of illicit drugs should also be noted because agents such as methylenedioxymethamphetamine have been linked to liver injury and, in some cases, acute liver failure (ALF). 12 Antibiotics and antiepileptics are the most commonly reported drugs, accounting for 60% of DILIs.…”

Liver diseases in pregnancy

“…The treatment is to stop the offending agent and monitor the synthetic function of the liver. 21 For viral hepatidides (such as hepatitis B), it is advised to reduce mother to child transmission, anti-viral therapy is recommended for viral levels >200,000 IU/mL. 22 Tenofovir, entecavir and lamivudine may all be used both in pregnancy and during breastfeeding.…”