"Study of Acute Fatty Liver of Pregnancy"with Literature Review
【摘要】：Objectives:Our aim is to explore the clinical outcome of patients with acute fatty liver of pregnancy (AFLP), and evaluate the effect of early diagnosis and treatment.
Methods:Seven patients who were diagnosed with acute fatty liver of pregnancy (AFLP) were retrospectively analyzed from February2005to January2013. The clinical records of the patients with AFLP were reviewed for clinical features, laboratory examinations, and maternal and perinatal prognosis. Routine laboratory evaluation revealed hyperbilirubinemia, moderately elevated liver transaminase, but negative serum hepatitis virus in each patient. For additional evidence,126cases of AFLP were reviewed retrospectively from original articles researched in A Medline-based English and Chinese Knowledge Infrastructure between the same periods.
Results:The initial symptoms of all the7cases with AFLP were gastrointestinal symptoms; anorexia, nausea, vomiting, and progressive jaundice. Complication revealed with renal insufficiency in all patients. Hepatic failure and multiple organ dysfunction syndrome (MODS), hypoglycemia, disseminated intravascular coagulation (DIC) failure in4patients (57.1%), hemorrhagic shock, ARDS, hepatic encephalopathy were seen in3patients (42.8%) and changes of coagulation function of different degrees occurred in a short time when the disease was serious. There was only one case of maternal death (14.2%), three cases of perinatal death (30%) and one postnatal death (10%).
Conclusion:AFLP occurs in late pregnancy, a rare clinical syndrome, occurred at about36weeks of gestation. Early diagnosis and prompt termination of pregnancy is the key of management, multidisciplinary collaboration, comprehensive treatment and effective prevention are helpful to improve prognosis of the cases with AFLP and perinatal death.