Acute Fatty Liver of Pregnancy (AFLP) is a rare but life-threatening complication of pregnancy that typically occurs in the third trimester. This study aimed to investigate the clinical and demographic features of patients with AFLP and evaluate the effectiveness of various treatment strategies. A total of five patients were diagnosed with AFLP between January 2020 and December 2022. The mean age of the patients was 28 years, with two patients having a history of diabetes, and two patients were COVID-19 positive. The mean gestational age at diagnosis was 31 weeks and 1 day, with two patients admitted for high blood pressure, one for sudden onset jaundice, and two for delivery. All patients met the Swansea criteria for AFLP diagnosis. Three patients developed neurological symptoms in the postpartum period, two with hypoglycemic coma due to liver failure and one with hepatic encephalopathy. Two patients had renal insufficiency, one with a hemorrhagic syndrome, and one with disseminated intravascular coagulation (DIC). All patients had thrombocytopenia, and two patients had a platelet count below 50,000. Obstetric ultrasound/doppler showed an evolving monofetal pregnancy in four cases and fetal demise in one case. Two patients were treated with therapeutic plasma exchange, and two underwent continuous renal replacement therapy until renal function normalized. The patient with a hemorrhagic syndrome received two units of platelets postpartum, while the patient with DIC received fresh frozen plasma. One patient had a vaginal delivery, while four patients had a cesarean section.
Due to routine maternal serum screening and fetal ultrasonography, gastrochisis is routinely found in utero, we report a case of gastrochisis diagnosed prenatally, the delivery was made by C-section and the patient was operated at day 1 of life with good outcome The surgical treatment of gastroschisis differs from hospital to hospital and has changed over the years, especially since the spring-loaded silo was invented. Every surgical repair has as its main objective the return of the viscera to the abdominal cavity while reducing the chance that the viscera would sustain harm from direct trauma or increased intra-abdominal pressure.Gatrochisis is remains a rare condition that be closed spontanouesly during the pregnancy and that can prevented by acid folic supplementation.
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