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[Acute fatty liver of pregnancy. About 22 cases].
Gynecol Obstet Fertil. 2006 Jul-Aug; 34(7-8):597-606.GO

Abstract

OBJECTIVE

To report the clinical experience, biochemical findings, complications and maternal outcome in patients with acute fatty liver of pregnancy (AFLP).

PATIENTS AND METHODS

Retrospective study over a period of 11 years (1993-2003). The diagnosis of AFLP was confirmed by liver biopsy in 15 women. However, in 7 women a medical committee that took into account clinical symptoms, and laboratory findings assessed the diagnosis.

RESULTS

Were included in this study, 22 women with a mean age of 30+/-5.4 years. Only 22.7% of cases were primigravid. The mean gestational age was 36+/-2.76 weeks (range 31-41 weeks). The fetus was a male infant in 75% of cases. Ten women were admitted in the hospital without jaundice. However 15 women had developed an icterus since their hospital admission or during ICU stay. The mean SAPS II on the ICU admission was of 24.86+/-11.2 points. Biological disturbances observed were mainly: liver cytolysis in 91% of cases, a trend to hypoglycaemia in 86%, a hypoprotidemia in 66.7% and CIVD in 32%. During their ICU stay, 19 women (86.4%) developed one or several organ failures associated to the hepatic failure and 18 women required blood transfusion. After an average stay of 7.5 days, evolution was marked by the death of seven patients (31.8%). Factors correlated with a poor prognosis were: the delay of medical consultation, the development of jaundice, the development of encephalopathy, respiratory or a circulatory failure.

DISCUSSION AND CONCLUSION

AFLP is a rare but life-threatening complication. Furthermore AFLP shares features with other more common and less perilous illnesses. An early diagnosis and appropriate therapy of this pathology should improve the poor prognosis in our country.

Links

Publisher Full Text

Authors+Show Affiliations

Bahloul M
Service de réanimation médicale, CHU Habib-Bourguiba, route El Ain, 3029 Sfax, Tunisie. bahloulmab@yahoo.fr
Dammak H
No affiliation info available
Khlaf-Bouaziz N
No affiliation info available
Trabelsi K
No affiliation info available
Khabir A
No affiliation info available
Ben Hamida C
No affiliation info available
Kallel H
No affiliation info available
Ksibi H
No affiliation info available
Chelly H
No affiliation info available
Chaari A
No affiliation info available
Rekik N
No affiliation info available
Bouaziz M
No affiliation info available

MeSH

Acute DiseaseAdultBlood TransfusionCritical CareFatty LiverFemaleGestational AgeHumansLiver FailureMaleMultiple Organ FailurePregnancyPregnancy ComplicationsPregnancy OutcomePrognosisRetrospective Studies

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

16822693

Citation

Bahloul, M, et al. "[Acute Fatty Liver of Pregnancy. About 22 Cases]." Gynecologie, Obstetrique & Fertilite, vol. 34, no. 7-8, 2006, pp. 597-606.
Bahloul M, Dammak H, Khlaf-Bouaziz N, et al. [Acute fatty liver of pregnancy. About 22 cases]. Gynecol Obstet Fertil. 2006;34(7-8):597-606.
Bahloul, M., Dammak, H., Khlaf-Bouaziz, N., Trabelsi, K., Khabir, A., Ben Hamida, C., Kallel, H., Ksibi, H., Chelly, H., Chaari, A., Rekik, N., & Bouaziz, M. (2006). [Acute fatty liver of pregnancy. About 22 cases]. Gynecologie, Obstetrique & Fertilite, 34(7-8), 597-606.
Bahloul M, et al. [Acute Fatty Liver of Pregnancy. About 22 Cases]. Gynecol Obstet Fertil. 2006 Jul-Aug;34(7-8):597-606. PubMed PMID: 16822693.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Acute fatty liver of pregnancy. About 22 cases]. AU - Bahloul,M, AU - Dammak,H, AU - Khlaf-Bouaziz,N, AU - Trabelsi,K, AU - Khabir,A, AU - Ben Hamida,C, AU - Kallel,H, AU - Ksibi,H, AU - Chelly,H, AU - Chaari,A, AU - Rekik,N, AU - Bouaziz,M, Y1 - 2006/07/05/ PY - 2005/11/28/received PY - 2006/05/24/accepted PY - 2006/7/11/pubmed PY - 2006/10/13/medline PY - 2006/7/11/entrez SP - 597 EP - 606 JF - Gynecologie, obstetrique & fertilite JO - Gynecol Obstet Fertil VL - 34 IS - 7-8 N2 - OBJECTIVE: To report the clinical experience, biochemical findings, complications and maternal outcome in patients with acute fatty liver of pregnancy (AFLP). PATIENTS AND METHODS: Retrospective study over a period of 11 years (1993-2003). The diagnosis of AFLP was confirmed by liver biopsy in 15 women. However, in 7 women a medical committee that took into account clinical symptoms, and laboratory findings assessed the diagnosis. RESULTS: Were included in this study, 22 women with a mean age of 30+/-5.4 years. Only 22.7% of cases were primigravid. The mean gestational age was 36+/-2.76 weeks (range 31-41 weeks). The fetus was a male infant in 75% of cases. Ten women were admitted in the hospital without jaundice. However 15 women had developed an icterus since their hospital admission or during ICU stay. The mean SAPS II on the ICU admission was of 24.86+/-11.2 points. Biological disturbances observed were mainly: liver cytolysis in 91% of cases, a trend to hypoglycaemia in 86%, a hypoprotidemia in 66.7% and CIVD in 32%. During their ICU stay, 19 women (86.4%) developed one or several organ failures associated to the hepatic failure and 18 women required blood transfusion. After an average stay of 7.5 days, evolution was marked by the death of seven patients (31.8%). Factors correlated with a poor prognosis were: the delay of medical consultation, the development of jaundice, the development of encephalopathy, respiratory or a circulatory failure. DISCUSSION AND CONCLUSION: AFLP is a rare but life-threatening complication. Furthermore AFLP shares features with other more common and less perilous illnesses. An early diagnosis and appropriate therapy of this pathology should improve the poor prognosis in our country. SN - 1297-9589 UR - https://www.unboundmedicine.com/medline/citation/16822693/[Acute_fatty_liver_of_pregnancy__About_22_cases]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1297-9589(06)00192-5 DB - PRIME DP - Unbound Medicine ER -