Acute fatty liver of pregnancy: a retrospective analysis of 13 cases

作者：Chen, Yun-Yan; Gu, Li-Ying; Di, Wen^*; Lin, Jian-Hua^*

来源：International Journal of Clinical and Experimental Pathology, 2017, 10(6): 7075-7081.

• Acute fatty liver of pregnancy (AFLP)
• early diagnosis
• prompt delivery
• intensive supportive care
• hepatorenal syndrome

Objective: Acute fatty liver of pregnancy (AFLP) is a rare life-threatening complication of pregnancy that occurs in the third trimester or the immediate period after delivery. This retrospective study aims to explore the early diagnosis methods and the principle of treatments of AFLP. Methods: The clinical presentation, complications, clinical diagnosis and management were determined in patients with acute fatty liver of pregnancy (AFLP). The maternal-perinatal mortality was analyzed with SPSS software (Version No. 16.0). Fisher exact texts were utilized to evaluated the difference of maternal-perinatal mortality. Study design: The clinical features, laboratory results, maternal and neonatal outcomes and treatments of thirteen AFLP patients were described retrospectively at Renji Hospital, School of Medicine, Shanghai Jiaotong University from Jul. 2007 to Aug. 2015. Results: All cases presented with a prodrome of digestive symptoms: rapidly progressing jaundice, nausea, vomiting, upper abdominal pain. (9/13, 69%). Laboratory results included quickly progressed cholenzyme separation (9/13, 69%), coagulation disorder (11/13, 85%), hypoproteinemia (9/13, 69%), hypoglycemia (5/13, 38%), renal impairment (11/13, 85%), elevated ammonia (8/13, 62%), negative hepatitis virus (100%). The mortality of maternal was 2/13 (15%), no neonatal death. The time between delivery and onset of 7 AFLP patients was over one week, all of these 7 patients had MOSF and 2 of them died, the maternal mortality was 28.57%, compared with the patients who's time between delivery and onset was within one week, the maternal mortality had statistical difference (P<0.05). The main treatments included prompt delivery and intensive supportive care. Giving intravenous albumin or in addition to dopamine and terlipressin were effective in the treatment of hepatorenal syndrome and also helpful to the recovery of liver function. Conclusions: Early diagnosis, prompt delivery and intensive supportive care are the cornerstones in the successful treatment of AFLP.

• 出版日期2017
• 单位上海交通大学