Toxic hepatitis: a rare complication associated with the use of ritodrine during pregnancy.

OBJECTIVES

To evaluate the incidence of toxic hepatitis associated with the use of ritodrine in pregnancy.

DESIGN

A prospective study.

SETTING

A large teaching hospital in Barcelona, Spain.

PATIENTS: One hundred and twenty-three consecutive pregnant women, 101 singleton and 22 multiple pregnancies, receiving intravenous ritodrine with normal transaminase levels prior to the initiation of therapy.

MEASUREMENTS: Serum glutamic pyruvic transaminase (SGPT) and glutamic oxaloacetic transaminase (SGOT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (PA), direct and total bilirubin.

RESULTS

In two (l.9%) of 101 singleton and two (9.1%) of 22 multiple pregnancies, elevation of SGOT and SGPT levels was detected. PA, GGT, and bilirubin were normal in all women studied. Other causes of hepatitis were ruled out, and no other signs of liver impairment were found in these women. Transaminase levels recovered rapidly in all cases after discontinuation of therapy.

CONCLUSION

Elevation of liver enzymes is a rare complication of ritodrine. Discontinuation of therapy does not appear to be indicated as long as other signs of liver dysfunction are not present and tocolytic treatment is required.