Acute fatty liver of pregnancy

Mjahed, K.; Charra, Boubker; Hamoudi, D.; Noun, M.; Barrou, Lhoucine

doi:10.1007/s00404-006-0203-6

Cited by 51 publications

(42 citation statements)

References 18 publications

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“…Such values are very low, especially in developed countries, due to early intensive treatment. However, in low-income regions, late diagnosis and inadequate ICU treatment result in much higher mortality rates (of approximately 20%) [37][38][39] than in high-income regions (where they are approximately 10%) [26,27,36]. In the present study, the mortality was 5.88% (95% CI: 0-29%), which is relatively low compared with all other previous reports.…”

Section: Discussioncontrasting

confidence: 60%

Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series

et al. 2011

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Acute fatty liver of pregnancy (AFLP) complicated by acute kidney injury (AKI) is serious and life-threatening for the mother. The present study aimed to determine the clinical efficacy of combined blood purification treatment (CBPT) in patients with AFLP complicated by AKI. The CBPT involves plasma exchange (PE) combined with continuous venovenous hemofiltration (CVVH). The subjects were 17 patients with AFLP complicated by AKI. The CBPT was implemented based on the timely termination of pregnancy and general treatment. Changes in clinical manifestations, laboratory tests, liver ultrasounds, as well as Sequential Organ Failure Assessment (SOFA) and Glasgow scores were evaluated. The efficacy and adverse reactions of the CBPT were also assessed. The CBPT was smoothly performed without any obvious adverse reaction. After treatment, the clinical manifestations, laboratory examinations, and liver ultrasonography significantly improved. Therefore, the SOFA scores correspondingly decreased 1 week after treatment [9 (range 5-11) vs. 3 (range 0-10), P = 0.002], and the median was close to normal by the second week. The clearance rate of the total bilirubin in PE was significantly higher than that in CVVH (37.2 vs. 7.9%, P = 0.000). The incidence of acute pulmonary edema in CVVH was less than that in PE (0 vs. 41.2%, P = 0.007). Finally, the maternal mortality was 5.88% (95% CI: 0-29%). Overall, we think that CBPT aids in the recovery of liver and kidney function. Different blood purification methods may be combined to integrate and maximize their advantages to improve the prognoses of patients with serious AFLP.

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Section: Discussioncontrasting

confidence: 60%

Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series

et al. 2011

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“…The maternal prognosis is currently greatly improved, and maternal mortality is about 10% or less worldwide [92,93]. This improvement is related principally to early delivery, to advances in intensive care support for patients with severe forms, and also to the detection of patients with less severe forms.…”

Section: Maternal and Fetal Outcomementioning

confidence: 99%

The Liver in Pregnancy

Bacq

2011

Schiff's Diseases of the Liver

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“…Rarely AFLP may present as asymptomatic elevation of transaminases [5]. Jaundice is seen on initial presentation in severe cases [133,171].…”

Section: Presentationmentioning

confidence: 99%

“…Delivery is often complicated with severe postpartum bleeding. Diabetes insipidus may complicate AFLP [7,171,172].…”

Section: Presentationmentioning

confidence: 99%

“…Patients are usually very ill and require intensive care unit or hepatic failure unit hospitalization with multidisciplinary team management [173]. Timely delivery after initial patient stabilization is a cure, as in most pregnancy-associated liver diseases [171,173,176]. Depending on the presence of the complications, complete recovery from AFLP may take anywhere from days to weeks.…”

Section: Managementmentioning

confidence: 99%

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Pregnancy-Associated Liver Disorders

Hepburn

2008

Dig Dis Sci

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Liver disorders associated with pregnancy include hyperemesis gravidarum (HG), intrahepatic cholestasis of pregnancy (ICP), preeclampsia, syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP), and acute fatty liver of pregnancy (AFLP). These conditions are relatively common and unique to pregnancy and are more likely to occur at certain terms of gestation specific to each condition. They can be associated with significant maternal and fetal morbidity and mortality. Although managing such patients may be very challenging, spontaneous resolution of the disease occurs shortly after termination of the pregnancy, usually without hepatic sequellae. Early diagnosis and timely treatment is a key to therapeutic success. This article explores the clinical features, pathophysiology, and management of these disorders.

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Acute fatty liver of pregnancy

Abstract: 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.

Cited by 51 publications

References 18 publications

Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series

Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series

The Liver in Pregnancy

Pregnancy-Associated Liver Disorders

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