Acute fatty liver of pregnancy complicated with disseminated intravascular coagulation and haemorrhage: a case report

Yücesoy, Gülseren; Özkan, Sebiha; Bodur, Harika; Çakıroğlu, Yiğit; Çalışkan, Ebru; Özeren, Semih

doi:10.1111/j.1368-504x.2005.00371.x

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…However, in some cases, liver and renal function, mental status, and coagulopathy continued to worsen for up to a week postpartum (11). Women with AFLP usually receive supportive management in an intensive care unit (2,(12)(13)(14)(15); however, in those complicated and severe cases, plasmapheresis has been recently used to improve maternal outcome. Martin's and his collogues have utilized postpartum plasma exchange as supplemental therapy for six patients with severe AFLP.…”

Section: Discussionmentioning

confidence: 99%

Plasmapheresis in the treatment of fatty liver of pregnancy: A case report

Ashrafganjoei

Mirreza

Eftekhariyazdi

et al. 2019

NPT

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Introduction: Acute fatty liver of pregnancy (AFLP) is a rare but lethal disease with liver involvement that appears in the third trimester of pregnancy. There is no specific treatment for AFLP. Because liver dysfunction is the most pathogenesis in AFLP the following hypothesis will be raised that plasma exchange can be useful. Case Report: A 26-year-old mother was referred to our emergency ward with AFLP. The ultrasonography reported a single alive anhydramnios fetus at 34 weeks and fatty liver G1-2. Emergent cesarean was performed and the patient was then admitted to the intensive care unit. The day after surgery, our patient developed periumbilical tenderness and displayed abnormal coagulative factors. Ultrasonography reported 500cc liquid in the abdominal space. Relaparotomy was performed and during the next several days, her general condition worsened and supportive treatment was not effective and the patient experienced a seizure. We started plasmapheresis and after 10 days platelet levels started to rise, lactate dehydrogenase began to reduce, the edema reduced significantly, and her orientation became better. We continued plasmapheresis for about 20 sessions. After one month, the patient was discharged from the hospital in good general condition. Conclusion: Plasmapheresis may be effective in the treatment of fatty liver of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Plasmapheresis in the treatment of fatty liver of pregnancy: A case report

Ashrafganjoei

Mirreza

Eftekhariyazdi

et al. 2019

NPT

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“…Women with AFLP usually receive conservative management in an intensive care unit because of the fatality of the condition (10,(14)(15)(16)(17). Therefore, the liver enzymes reduced after three days, but AFLP predisposed our patient to coagulation disorder and hematoma development which was cured with a conservative management.…”

Section: Discussionmentioning

confidence: 99%

Case of Complicated Fatty Liver of Pregnancy With Good Outcome

Eftekhariyazdi

Souizi

Moghaddam

et al. 2019

International Journal of Women’s Health and Reproduction Scienc

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Acute fatty liver of pregnancy (AFLP) is a rare condition with an incidence rate of 1 to 20 000 that mostly occurs in the third trimester of pregnancy. There is no specific treatment for AFLP thus a conservative treatment is usually applied in this regard. This case report is related to a 28-year-old G3 P1 Ab1 L1 woman at 29 weeks of pregnancy who was referred to our emergency ward from a primary setting with an epigastric pain, a mild hypertension, and the suspicion of HELLP [Hemolysis, elevated liver enzymes, and low platelet count] syndrome. The lab exams ruled out viral infections including hepatitis B virus (HBV), hepatitis C virus (HCV), and Human immunodeficiency virus (HIV). In addition, the urine protein was 40 mg/600 cc. AFLP was diagnosed and a cesarean was performed under spinal analgesia because of elevated liver enzymes, proteinuria in the normal range for pregnancy, the presence of viral infections that involved the liver, and lack of pruritus. A 29-week girl with a weight of 1115 g was born and the patient was discharged with a good condition. At 5 days postpartum, she referred with abdominal pain, fever, as well as incisional redness and discharge. The ultrasound scan showed a hematoma in the depth of the subdermis point of the cesarean incision. Thus, antibiotics and one unit of fresh frozen plasma were infused. On 14-day postpartum, the patient was discharged with a good condition. The purpose of this study was to focus the attention of physicians to the point that AFLP may improve after childbirth but it may predispose the patient to coagulation disorders and hematoma.

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“…A delay in the diagnosis of this obstetric emergency may lead to a rapid progress to hepatic failure, (DIC), hemorrhage, encephalopathy, multiple organ failure, and finally death. [9] There is no specific treatment, but screening the newborn at birth in pregnancies complicated by AFLP for this metabolic disorder can be life-saving with appropriate dietary modifications, and genetic counseling in subsequent pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Acute fatty liver of pregnancy mimicking puerperal sepsis: Report of a case with literature review

Masoodi

Al-Lehibi²,

Wani³

et al. 2016

Saudi J Med Med Sci

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Puerperal pyrexia is defined as fever in a woman within 6 weeks of giving birth, which is ≥38°C. We describe the clinical scenario of fever and progressive jaundice in a 32-year-old female in the postpartum period. The laboratory data showed normal leukocytic counts and all her septic screen was noncontributory. While in the hospital, her bilirubin levels progressively increased and showed a mild elevation of liver enzymes. There was no evidence of biliary obstruction. A liver biopsy clinched the diagnosis of acute fatty liver. Acute fatty liver of pregnancy is a rare but serious complication of pregnancy. It typically presents in the third trimester and can lead to multi-organ failure and death. This report highlights the importance of liver biopsy and an atypical presentation of fatty liver of pregnancy.

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Acute fatty liver of pregnancy complicated with disseminated intravascular coagulation and haemorrhage: a case report

Cited by 8 publications

References 14 publications

Plasmapheresis in the treatment of fatty liver of pregnancy: A case report

Plasmapheresis in the treatment of fatty liver of pregnancy: A case report

Case of Complicated Fatty Liver of Pregnancy With Good Outcome

Acute fatty liver of pregnancy mimicking puerperal sepsis: Report of a case with literature review

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