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Acute fatty liver of pregnancy.
Arch Gynecol Obstet. 2006 Oct; 274(6):349-53.AG

Abstract

OBJECTIVE

Acute fatty liver of pregnancy (AFLP) is a rare and serious entity associated with significant maternal and neonatal mortality and morbidity. We describe our experience with the clinical diagnosis, management and course patients with AFLP.

STUDY DESIGN

Medical records of patients with AFLP were reviewed over a 10-year period. Records were reviewed for symptoms, laboratory findings, clinical course, and maternal and perinatal outcomes.

RESULTS

The incidence of AFLP was 1 in 7,270 births. The mean gestational age at onset was 34.6 +/- 4.9 weeks. Eight percent of the patients were multiparous with more than three pregnancies. The prodromic phase was variable; patients complained of nausea, abdominal pain, malaise, polyuria-polydipsia syndrome and headaches followed by jaundice. The laboratory results indicated coagulopathy, liver function abnormalities and hypoglycemia. Emergency cesarean section was performed in two cases. The diagnosis has been assessed by transcutaneous hepatic biopsies processed in all patients between the 4th and 15th day (8.4 +/- 4.3 days). Maternal morbidity included hypoglycaemia (40%), coagulopathy (50%) encephalopathy (30%) and renal failure (40%). There were no maternal deaths but fetal mortality is high 66%.

CONCLUSION

The early recognition of AFLP cases and prompt progressive management, including early termination of pregnancy and large dose infusion of fresh frozen plasma, the prognosis of AFLP is obviously improved.

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Authors+Show Affiliations

Mjahed K
Department of Anaesthesia and Intensive Care, Ibn Rochd University Hospital, 125, Rue Larache Hay Essalam C.I.L, Casablanca, 20 200, Morocco. kmjahed@yahoo.fr
Charra B
No affiliation info available
Hamoudi D
No affiliation info available
Noun M
No affiliation info available
Barrou L
No affiliation info available

MeSH

Acute DiseaseAdultBilirubinFatty LiverFemaleFetal DeathGestational AgeHumansLength of StayParityPregnancyPregnancy ComplicationsProthrombin TimeRetrospective StudiesTransaminases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16868757

Citation

Mjahed, Khalid, et al. "Acute Fatty Liver of Pregnancy." Archives of Gynecology and Obstetrics, vol. 274, no. 6, 2006, pp. 349-53.
Mjahed K, Charra B, Hamoudi D, et al. Acute fatty liver of pregnancy. Arch Gynecol Obstet. 2006;274(6):349-53.
Mjahed, K., Charra, B., Hamoudi, D., Noun, M., & Barrou, L. (2006). Acute fatty liver of pregnancy. Archives of Gynecology and Obstetrics, 274(6), 349-53.
Mjahed K, et al. Acute Fatty Liver of Pregnancy. Arch Gynecol Obstet. 2006;274(6):349-53. PubMed PMID: 16868757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute fatty liver of pregnancy. AU - Mjahed,Khalid, AU - Charra,Boubker, AU - Hamoudi,Driss, AU - Noun,Mohamed, AU - Barrou,Lhoucine, Y1 - 2006/07/26/ PY - 2006/04/29/received PY - 2006/06/20/accepted PY - 2006/7/27/pubmed PY - 2007/2/28/medline PY - 2006/7/27/entrez SP - 349 EP - 53 JF - Archives of gynecology and obstetrics JO - Arch Gynecol Obstet VL - 274 IS - 6 N2 - OBJECTIVE: Acute fatty liver of pregnancy (AFLP) is a rare and serious entity associated with significant maternal and neonatal mortality and morbidity. We describe our experience with the clinical diagnosis, management and course patients with AFLP. STUDY DESIGN: Medical records of patients with AFLP were reviewed over a 10-year period. Records were reviewed for symptoms, laboratory findings, clinical course, and maternal and perinatal outcomes. RESULTS: The incidence of AFLP was 1 in 7,270 births. The mean gestational age at onset was 34.6 +/- 4.9 weeks. Eight percent of the patients were multiparous with more than three pregnancies. The prodromic phase was variable; patients complained of nausea, abdominal pain, malaise, polyuria-polydipsia syndrome and headaches followed by jaundice. The laboratory results indicated coagulopathy, liver function abnormalities and hypoglycemia. Emergency cesarean section was performed in two cases. The diagnosis has been assessed by transcutaneous hepatic biopsies processed in all patients between the 4th and 15th day (8.4 +/- 4.3 days). Maternal morbidity included hypoglycaemia (40%), coagulopathy (50%) encephalopathy (30%) and renal failure (40%). There were no maternal deaths but fetal mortality is high 66%. CONCLUSION: The early recognition of AFLP cases and prompt progressive management, including early termination of pregnancy and large dose infusion of fresh frozen plasma, the prognosis of AFLP is obviously improved. SN - 0932-0067 UR - https://www.unboundmedicine.com/medline/citation/16868757/Acute_fatty_liver_of_pregnancy_ L2 - https://dx.doi.org/10.1007/s00404-006-0203-6 DB - PRIME DP - Unbound Medicine ER -