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[The pregnant patient with acute liver disease].
Ned Tijdschr Geneeskd. 2002 Aug 03; 146(31):1433-7.NT

Abstract

Acute liver disease was diagnosed in three pregnant patients: two 30-year-old women had a 'haemolysis, elevated liver enzymes, low platelets' (HELLP) syndrome and acute fatty liver of pregnancy, respectively, and a 20-year-old woman had acute liver failure due to acute hepatitis B. The first two patients had a caesarean section, the third one delivered her child, which died spontaneously shortly after birth at a gestational age of 23 weeks. She was then treated by liver transplantation. All three patients left the hospital in good condition. Liver diseases in pregnancy may be pregnancy-related, e.g. the HELLP syndrome and acute fatty liver of pregnancy, but they may also be coincidental phenomena, e.g. viral hepatitis. The HELLP syndrome is often associated with pre-eclampsia, and presents with epigastric pain and thrombocytopenia with haemolysis. Acute fatty liver disease and acute liver failure due to hepatitis present with liver insufficiency characterised by anorexia, nausea, coagulopathy, hypoglycaemia and elevated serum ammonia levels. Management depends on the diagnosis and the gestational age; pregnancy complicated by acute fatty liver disease should be terminated while pregnancy complicated by the HELLP syndrome early in pregnancy may be maintained to improve the outcome of the foetus. In acute liver failure due to viral hepatitis, termination of pregnancy alone does not affect the disease.

Authors+Show Affiliations

Siemens FC
Afd. Verloskunde en Vrouwenziekten, Erasmus Medisch Centrum, locatie Sophia Kinderziekenhuis, Dr. Molewaterplein 50, 3015 GD Rotterdam.
Visser W
No affiliation info available
Metselaar HJ
No affiliation info available
Zondervan PE
No affiliation info available
de Groot CJ
No affiliation info available

MeSH

Abortion, InducedAdultFatty LiverFemaleGestational AgeHELLP SyndromeHepatitis BHumansInfant, NewbornLiver DiseasesLiver Failure, AcuteLiver TransplantationPregnancyPregnancy ComplicationsPregnancy Outcome

Pub Type(s)

Case Reports
Comment
English Abstract
Journal Article

Language

dut

PubMed ID

12190007

Citation

Siemens, F C., et al. "[The Pregnant Patient With Acute Liver Disease]." Nederlands Tijdschrift Voor Geneeskunde, vol. 146, no. 31, 2002, pp. 1433-7.
Siemens FC, Visser W, Metselaar HJ, et al. [The pregnant patient with acute liver disease]. Ned Tijdschr Geneeskd. 2002;146(31):1433-7.
Siemens, F. C., Visser, W., Metselaar, H. J., Zondervan, P. E., & de Groot, C. J. (2002). [The pregnant patient with acute liver disease]. Nederlands Tijdschrift Voor Geneeskunde, 146(31), 1433-7.
Siemens FC, et al. [The Pregnant Patient With Acute Liver Disease]. Ned Tijdschr Geneeskd. 2002 Aug 3;146(31):1433-7. PubMed PMID: 12190007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The pregnant patient with acute liver disease]. AU - Siemens,F C, AU - Visser,W, AU - Metselaar,H J, AU - Zondervan,P E, AU - de Groot,C J M, PY - 2002/8/23/pubmed PY - 2002/11/26/medline PY - 2002/8/23/entrez SP - 1433 EP - 7 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 146 IS - 31 N2 - Acute liver disease was diagnosed in three pregnant patients: two 30-year-old women had a 'haemolysis, elevated liver enzymes, low platelets' (HELLP) syndrome and acute fatty liver of pregnancy, respectively, and a 20-year-old woman had acute liver failure due to acute hepatitis B. The first two patients had a caesarean section, the third one delivered her child, which died spontaneously shortly after birth at a gestational age of 23 weeks. She was then treated by liver transplantation. All three patients left the hospital in good condition. Liver diseases in pregnancy may be pregnancy-related, e.g. the HELLP syndrome and acute fatty liver of pregnancy, but they may also be coincidental phenomena, e.g. viral hepatitis. The HELLP syndrome is often associated with pre-eclampsia, and presents with epigastric pain and thrombocytopenia with haemolysis. Acute fatty liver disease and acute liver failure due to hepatitis present with liver insufficiency characterised by anorexia, nausea, coagulopathy, hypoglycaemia and elevated serum ammonia levels. Management depends on the diagnosis and the gestational age; pregnancy complicated by acute fatty liver disease should be terminated while pregnancy complicated by the HELLP syndrome early in pregnancy may be maintained to improve the outcome of the foetus. In acute liver failure due to viral hepatitis, termination of pregnancy alone does not affect the disease. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/12190007/[The_pregnant_patient_with_acute_liver_disease]_ DB - PRIME DP - Unbound Medicine ER -