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Acute fatty liver of pregnancy: diagnosis, treatment, and outcome based on 35 consecutive cases.
J Matern Fetal Neonatal Med. 2011 Sep; 24(9):1143-6.JM

Abstract

OBJECTIVE

We describe our experience with the clinical diagnosis, management and, course of patients with acute fatty liver of pregnancy (AFLP).

METHODS

During the period between January 1996 and June 2010, medical records of patients with AFLP were reviewed for symptoms, laboratory findings, clinical course, and maternal and perinatal outcomes. Routine laboratory evaluation included serial measurement of liver function tests, complete blood cell counts, coagulation profile, and renal function tests.

RESULTS

During the study period 35 women had AFLP as the discharge diagnosis. The mean gestational age at delivery was 36 weeks, 39% were nulliparous and 4 had multiple gestation. The most common presenting symptom was nausea/vomiting (88.5%), jaundice (71.4%), and abdominal pain (51.4%). Maternal morbidity included hypoglycemia (94.2%), renal failure (94.2%), coagulopathy (77.1%), ascites (48.5%), and encephalopathy (40%). There were four maternal deaths (11.4%) and five perinatal deaths (12.5%).

CONCLUSION

We found a typical 'AFLP-Triad' in women with AFLP. First (symptoms): nausea/vomiting, jaundice, epigastric pain; second (laboratory): results indicated renal dysfunction, coagulopathy, liver function abnormalities, low glycemia, and third (complications): renal failure, coagulopathy, ascites, and encephalopathy. We recommended that patients with this triad received evaluation to rule out the diagnosis of AFLP.

Authors+Show Affiliations

Critical Care Unit, Department of Obstetrics and Gynecology, Social security, Panama, Panama. pvigild@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21668324

Citation

Vigil-de Gracia, Paulino, and Carlos Montufar-Rueda. "Acute Fatty Liver of Pregnancy: Diagnosis, Treatment, and Outcome Based On 35 Consecutive Cases." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, vol. 24, no. 9, 2011, pp. 1143-6.
Vigil-de Gracia P, Montufar-Rueda C. Acute fatty liver of pregnancy: diagnosis, treatment, and outcome based on 35 consecutive cases. J Matern Fetal Neonatal Med. 2011;24(9):1143-6.
Vigil-de Gracia, P., & Montufar-Rueda, C. (2011). Acute fatty liver of pregnancy: diagnosis, treatment, and outcome based on 35 consecutive cases. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 24(9), 1143-6. https://doi.org/10.3109/14767058.2010.531325
Vigil-de Gracia P, Montufar-Rueda C. Acute Fatty Liver of Pregnancy: Diagnosis, Treatment, and Outcome Based On 35 Consecutive Cases. J Matern Fetal Neonatal Med. 2011;24(9):1143-6. PubMed PMID: 21668324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute fatty liver of pregnancy: diagnosis, treatment, and outcome based on 35 consecutive cases. AU - Vigil-de Gracia,Paulino, AU - Montufar-Rueda,Carlos, Y1 - 2011/06/13/ PY - 2011/6/15/entrez PY - 2011/6/15/pubmed PY - 2012/1/24/medline SP - 1143 EP - 6 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J Matern Fetal Neonatal Med VL - 24 IS - 9 N2 - OBJECTIVE: We describe our experience with the clinical diagnosis, management and, course of patients with acute fatty liver of pregnancy (AFLP). METHODS: During the period between January 1996 and June 2010, medical records of patients with AFLP were reviewed for symptoms, laboratory findings, clinical course, and maternal and perinatal outcomes. Routine laboratory evaluation included serial measurement of liver function tests, complete blood cell counts, coagulation profile, and renal function tests. RESULTS: During the study period 35 women had AFLP as the discharge diagnosis. The mean gestational age at delivery was 36 weeks, 39% were nulliparous and 4 had multiple gestation. The most common presenting symptom was nausea/vomiting (88.5%), jaundice (71.4%), and abdominal pain (51.4%). Maternal morbidity included hypoglycemia (94.2%), renal failure (94.2%), coagulopathy (77.1%), ascites (48.5%), and encephalopathy (40%). There were four maternal deaths (11.4%) and five perinatal deaths (12.5%). CONCLUSION: We found a typical 'AFLP-Triad' in women with AFLP. First (symptoms): nausea/vomiting, jaundice, epigastric pain; second (laboratory): results indicated renal dysfunction, coagulopathy, liver function abnormalities, low glycemia, and third (complications): renal failure, coagulopathy, ascites, and encephalopathy. We recommended that patients with this triad received evaluation to rule out the diagnosis of AFLP. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/21668324/Acute_fatty_liver_of_pregnancy:_diagnosis_treatment_and_outcome_based_on_35_consecutive_cases_ DB - PRIME DP - Unbound Medicine ER -