The Hibernating Bear—A Good Analogy to Explain Why Acute Fatty Liver of Pregnancy Manifests in Late Pregnancy

2018 ◽  
Vol 113 (2) ◽  
pp. 307-308 ◽  
Author(s):  
Uday Zachariah ◽  
Ashish Goel ◽  
K A Balasubramanian ◽  
C E Eapen
Keyword(s):  
Fatty Liver ◽  
Late Pregnancy ◽  
Acute Fatty Liver ◽  
Good Analogy

scholarly journals Plasmapheresis in Acute Fatty Liver of Pregnancy: An Effective Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Mohammad Reza Seyyed Majidi ◽  
Jamshid Vafaeimanesh
Keyword(s):  
Renal Failure ◽  
Fatty Liver ◽  
Effective Treatment ◽  
Late Pregnancy ◽  
Termination Of Pregnancy ◽  
Time Interval ◽  
Effective Treatment Option ◽  
First Case ◽  
Life Saving ◽  
Acute Fatty Liver

Acute fatty liver of pregnancy (AFLP) is an idiopathic disorder with an unknown cause occurring in late pregnancy. The treatment in these patients is often immediate termination of pregnancy, and plasmapheresis provides an effective treatment option. In this paper, we introduce three pregnant women treated with plasmapheresis. The first case was a 22-year-old primigravida woman treated with 22 sessions of plasmapheresis due to AFLP, hepatic and renal failure, coagulopathy, and ventilator-dependent respiratory failure. The second case was a 23-year-old woman in her second pregnancy treated with 4 plasmapheresis sessions due to AFLP, hepatic and renal failure, coagulopathy, and hypoglycemia. The third patient was a 23-year-old primigravida woman treated with 3 plasmapheresis sessions due to AFLP, renal failure, and coagulopathy. Plasmapheresis can be a life-saving treatment in patients with AFLP and is strongly recommended for patients with severity of their disease accompanied by other organ disorders. In addition, shortening the time interval between the termination of pregnancy and initializing plasmapheresis improves the outcome and reduces the duration of hospital stay and sessions of plasmapheresis.

scholarly journals Liver diseases unique to pregnancy

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 337 ◽  
Author(s):  
Jūratė Kondrackienė ◽  
Limas Kupčinskas
Keyword(s):  
Fatty Liver ◽  
Liver Diseases ◽  
Hyperemesis Gravidarum ◽  
Correct Diagnosis ◽  
Late Pregnancy ◽  
First Trimester ◽  
Third Trimester ◽  
Liver Disorders ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver

The aim of this review article is to improve knowledge of the liver disease in pregnancy. The article summarizes the results of own experience and the recent reviews of liver disorders unique to pregnancy. Abnormalities in liver tests occur in 3% of pregnancies with causes ranging from self-limiting to rapidly fatal. In Kaunas University of Medicine Hospital, a retrospective analysis disclosed a rate of 0.52% of liver diseases in 16252 pregnant women over a 5-year period. Several liver diseases occur only during pregnancy and are considered to be associated with the pregnant state. The liver disorders unique to pregnancy have characteristic clinical features and timing of onset. Hyperemesis gravidarum occurs in the first trimester, intrahepatic cholestasis of pregnancy in the second or third trimester, preeclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and acute fatty liver of pregnancy usually in the third trimester. The disorders of late pregnancy – preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy – may progress to severe liver dysfunction. The correct diagnosis is critical, as any delay can result in morbidity or mortality of both the mother and fetus. Early delivery and advances in supportive management are the only available option for improving the prognosis.

scholarly journals Acute Fatty Liver of Pregnancy1

1983 ◽  
Vol 76 (8) ◽  
pp. 652-661 ◽  
Author(s):  
W M Hague ◽  
D W Fenton ◽  
S L B Duncan ◽  
D N Slater
Keyword(s):  
Fatty Liver ◽  
Rare Disease ◽  
World Literature ◽  
Metabolic Stress ◽  
Late Pregnancy ◽  
The World ◽  
Acute Fatty Liver

Six further cases of acute fatty liver of pregnancy are presented and discussed in relation to the world literature on this rare disease of pregnancy, the aetiology of which is still unknown. The importance of vomiting in late pregnancy is emphasized. A common feature seems to be a metabolic stress, possibly related to infection, which tips a susceptible liver into metabolic failure.

scholarly journals Pregnancy-related liver pathology: hyperemesis gravidarum, cholestatic hepatosis of pregnancy, preeclampsia/eclampsia, HELLP-syndrome, acute fatty liver of pregnancy

2021 ◽  
Vol 1 ◽  
pp. 7-16
Author(s):  
О.V. Golyanovskiy ◽  
N.E.  Geints ◽  
V.V.  Mekhedko ◽  
S.V.  Frolov
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Pregnant Women ◽  
Liver Dysfunction ◽  
Hellp Syndrome ◽  
Liver Diseases ◽  
Hyperemesis Gravidarum ◽  
Late Pregnancy ◽  
Risk Groups ◽  
Acute Fatty Liver

Liver disease associated with pregnancy affects up to 3% of women and is a common cause of dysfunction during pregnancy. Severe liver dysfunction is associated with high rates of maternal and infant morbidity and mortality.Therefore, it is important to know about liver diseases the woman suffered before pregnancy in order to adequately manage the pregnancy and reduce the number of complications during delivery. Research and recent advances in medicine tend to improve the consequences, but so far they have not shown significant reduction of the maternal and perinatal morbidity rates against the background of this pathology. Liver diseases that are characteristic for pregnancy can be classified into those of early pregnancy (hyperemesis gravidarum) and those of late pregnancy (preeclampsia/eclampsia, intrahepatic cholestasis of pregnant women; hemolysis, increased activity of liver enzymes) HELLP-syndrome, acute fatty liver disease of pregnant women - AFLP, liver rupture / infarction).The results of modern studies used in the practice of medical care for pregnant women with concomitant pathology have significantly improved the pregnancy and delivery outcomes, but the number of complications among the mother and the fetus is still high. In this article, we offer an overview of liver diseases complicated by pregnancy with a detailed presentation of their aetiology, pathogenesis, diagnosis, and treatment. The risk groups of pregnant women with the potential possibility of liver dysfunction development have also been identified.

Acute Fatty Liver of Pregnancy From 18 Weeks’ Gestation

Hepatology ◽  
2020 ◽  
Vol 71 (6) ◽  
pp. 2167-2169 ◽  
Author(s):  
Mimi Wong ◽  
Frances Hills ◽  
Katrina Vogler ◽  
Ibrahim Zardawi ◽  
Nirjhar Nandi
Keyword(s):  
Fatty Liver ◽  
Acute Fatty Liver

scholarly journals Diabetes Insipidus Accompanied with Acute Kidney Injury, which was Revealed by Acute Fatty Liver of Pregnancy.

2011 ◽  
Vol 100 (10) ◽  
pp. 3044-3047
Author(s):  
Hiroki Takimoto ◽  
Katsuyuki Nagatoya ◽  
Yoko Yamauchi ◽  
Hirohisa Matsuda ◽  
Tatsuhiko Mori ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Fatty Liver ◽  
Diabetes Insipidus ◽  
Kidney Injury ◽  
Acute Fatty Liver

Acute Fatty Liver

2018 ◽  
pp. 13-15
Author(s):  
Aiyuan Li ◽  
Weike Tao
Keyword(s):  
Fatty Liver ◽  
Acute Fatty Liver

scholarly journals ACUTE FATTY LIVER OF PREGNANCY MASQUERADING AS HELLP SYNDROME

2018 ◽  
Vol 5 (20) ◽  
pp. 1592-1595
Author(s):  
Santhosh Narayanan ◽  
Divya Prakash ◽  
Gomathy Subramaniam ◽  
Lakshminarayanan Lakshminarayanan
Keyword(s):  
Fatty Liver ◽  
Hellp Syndrome ◽  
Acute Fatty Liver

scholarly journals Comparison of Maternal and Neonatal Outcomes between Acute Fatty Liver of Pregnancy and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen
Keyword(s):  
Cohort Study ◽  
Fatty Liver ◽  
Retrospective Cohort Study ◽  
Hellp Syndrome ◽  
Retrospective Cohort ◽  
Liver Enzymes ◽  
Neonatal Outcomes ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver ◽  
Maternal And Neonatal Outcomes

Abstract Background: Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome.Methods: This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were analyzed.Results: During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0% versus 23.8%) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7% versus 13.8%), acute kidney injury (61.9% versus 15.0%), disseminated intravascular coagulopathy (66.7% versus 8.8%), and sepsis (47.6% versus 10.0%) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1% versus 33.3%), neonatal respiratory distress syndrome (39.2% versus 8.3%) and neonatal sepsis (34.2% versus 12.5%) were noted in the HELLP syndrome group.Conclusions: AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.

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