17 September 2020
: Case report
Delayed Fulminant Hepatic Failure from Dydrogesterone-Related In Vitro Fertilization Therapy Requiring Liver Transplantation During Pregnancy
Unusual clinical course, Unusual or unexpected effect of treatment, Unexpected drug reaction
Jacques A.J. Malherbe12ABCDEF, George Garas123ABCDEF, Tze S. Khor4ABCDE, Gerry C. MacQuillan123ABCDEF*DOI: 10.12659/AJCR.925690
Am J Case Rep 2020; 21:e925690
Figure 2. Representative macroscopic and microscopic images of the patient’s liver and placenta. (A) Gross morphology of the liver with submassive hepatic necrosis demonstrating capsular wrinkling and flattening (*) with developing regenerative nodularity (arrow) in portions of the liver. (B) Histologic examination of the liver demonstrating submassive hepatic necrosis characterized by complete loss of hepatocytes and inflammation (right and upper portion of image), with early regenerative nodularity (lower left portion of image). (Original magnification ×40.) (C) Histologic examination of the placenta demonstrating evidence of chorioamnionitis characterized by subchorionic fibrin (*) with admixed neutrophils and neutrophilic infiltration of the chorionic plate (arrows). (Original magnification ×400.) (D) Histologic examination of the placenta demonstrating extensive accumulation of intervillous blood with perivillous fibrin deposition (*) and early ischemic change of villi (arrows). (Original magnification ×200.)