Acute fatty liver of pregnancy at 19 weeks and 0 days of gestation after prolonged hyperemesis gravidarum

2021 ◽  
Author(s):  
Airi Komura ◽  
Yushiro Komatsu ◽  
Takao Yamamoto ◽  
Saki Tsuchimochi ◽  
Gaku Kurishita ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Hyperemesis Gravidarum ◽  
Acute Fatty Liver

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 Study of Pregnancy related AKI in Egyptian patients: Incidence, Risk factors and Outcome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Elshinnawy ◽  
H M Aref ◽  
K M Rezk ◽  
A M Elkotb ◽  
A Y Mohamed
Keyword(s):  
Fatty Liver ◽  
Plasma Exchange ◽  
Diagnostic Criteria ◽  
Hyperemesis Gravidarum ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Close Monitoring ◽  
Major Health Problem ◽  
Egyptian Patients ◽  
Acute Fatty Liver

Abstract Background Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it causes devastating maternal and fetal outcomes. In developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains a major health problem in the developing countries. Aim of the work in the present study, we determine the incidence, etiology and outcome of PRAKI in a sample of Egyptian patients. Methods Prospective observational study to determine the incidence, etiology and outcome of PRAKI was conducted over a period of one year from January to December 2017 at Ain Shams university obstetrics & gynecology hospital. Patients were enrolled in this study once PRAKI at antepartum as well as postpartum period was diagnosed according to the definition of KDIGO AKI guidelines diagnostic criteria Results During the period of the study a total of 13050 obstetric patients were admitted in Ain Shams university obstetrics & gynecology hospital. In total, 78 patients met the diagnostic criteria of PRAKI representing an incidence of 0.59% (78/13050). Pre-eclampsia & sepsis were the two most common causes of PRAKI, others were dehydration, postpartum hge, antepartum hge, UTI, proteinuria for investigation, SLE activity, DIC, TTP, Acute fatty liver of pregnancy, eclampsia, eclampsia complicated with HELLP syndrome, eclampsia with acute fatty liver of pregnancy, HUS, hyperemesis gravidarum, hypertensive emergency. Fifty five patients (70.5%) received conservative management. Hemodialysis was initiated in twelve patients (15.3%) based on standard indication (azotemia, oliguria volume overload, hyperkalemia and/or metabolic acidosis). Hemodialysis and plasma exchange was used for four patients (5.1%). Plasma exchange was indicated for seven patients. None of the patients received peritoneal dialysis or continuous renal replacement therapy. The ultimate evolution was good in 47 (60%) patients with complete recovery of the kidney function.14 women (17.9%) had an increased serum creatinine level at discharge for follow up at outpatient clinic. 6 patients (7.6%) had kept with advanced renal failure requiring hemodialysis. There were 11 cases of death, mortality rate was 14%. Conclusion AKI during pregnancy poses a challenge for physicians. In view of the multifaceted problems that potentially complicate pregnancy in women with AKI. Fortunately, with ongoing improvements in obstetrical care, multidisciplinary approaches comprising nephrologists, obstetricians and neonatologists maternal and perinatal mortality in this setting are largely avoidable. Therefore early recognition of signs and symptoms, close monitoring in high risk cases, early referral and a multidisciplinary team management could potentially prevent progression to higher stages of PRAKI and reduce morbidity and mortality.

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

Readiness, Recognition, Response, and Reporting in a Case of Acute Fatty Liver of Pregnancy

2018 ◽  
Vol 22 (6) ◽  
pp. 481-488
Author(s):  
Jane Ciaramella
Keyword(s):  
Fatty Liver ◽  
Recognition Response ◽  
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.

scholarly journals Sickle cell anaemia in vaso-occlusive crisis and acute fatty liver of pregnancy: a case report

2020 ◽  
Vol 54 (3) ◽  
pp. 201-203
Author(s):  
Michael Ezeanochie ◽  
Oghenefegor Olokor ◽  
Ofure Yamah
Keyword(s):  
Case Report ◽  
Fatty Liver ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Elevated Serum ◽  
Simultaneous Occurrence ◽  
Published Data ◽  
Care Providers ◽  
Delay In Diagnosis ◽  
Acute Fatty Liver

Acute fatty liver of pregnancy (AFLP) is an uncommon condition that manifests in the third trimester of pregnancy.Its association with vaso-occlusive crisis from Sickle Cell Anaemia is not common. Published data on the simultaneous occurrence of these two conditions is rare, hence this case report. A 32-year-old gravida 3 para 1+1 lady, with Sickle Cell Anaemia, had a vaso-occlusive crisis in association with AFLP at 32 weeks’ gestation, and the outcome of her management was successful. AFLP is a rare late-gestational event affecting about 1 in 10,000 to 15,000 pregnancies. The exact aetiology is not known. Profound hypoglycaemia and jaundice with elevated serum transaminases are recognized features of AFLP.These features may also be seen in haemoglobinopathies. The simultaneous occurrence of AFLP and Sickle Cell Anaemia may result in overlap of symptoms and delay in diagnosis and treatment. Therefore, maintaining a high index of suspicion is key. The cornerstone for treatment remains prompt delivery and supportive care. AFLP can coexist with Sickle cell crises. It is important that care providers, especially in populations with high burden of Sickle Cell Anaemia, consider this as a differential diagnosis, especially when the jaundice is associated with profound or recurring episodes of hypoglycaemia. Prompt diagnosis and delivery in a multidisciplinary approach is important to avoid adverse maternal and foetal outcomes.Keywords: Vaso-occlusive crises, acute fatty liver of pregnancy, hypoglycaemia, Sickle-cell anaemiaFunding: No funding sources

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