scholarly journals S2671 Severe Acute Liver Injury From Post-Partum HELLP Syndrome/Acute Fatty Liver of Pregnancy Overlap Improved With Plasmapheresis

2021 ◽  
Vol 116 (1) ◽  
pp. S1120-S1120
Author(s):  
Mujtaba Mohamed ◽  
Wesam Frandah ◽  
MD mai Thanda Han
2018 ◽  
Vol 5 (20) ◽  
pp. 1592-1595
Author(s):  
Santhosh Narayanan ◽  
Divya Prakash ◽  
Gomathy Subramaniam ◽  
Lakshminarayanan Lakshminarayanan

2020 ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen

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.


2018 ◽  
Vol 45 (1) ◽  
pp. 96-103 ◽  
Author(s):  
Hirotada Suzuki ◽  
Shiho Nagayama ◽  
Chikako Hirashima ◽  
Kayo Takahashi ◽  
Hironori Takahashi ◽  
...  

2019 ◽  
Vol 220 (1) ◽  
pp. S561 ◽  
Author(s):  
John J. Byrne ◽  
Angela Seasely ◽  
Donald McIntire ◽  
David B. Nelson ◽  
F. Gary Cunningham

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen

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 compared. We analyzed the categorical variables with Chi-square test or Fisher’s exact test and continuous variables with Student’s t test or Mann-Whitney U test. Subsequent logistic regression analyses adjusting by potential confounding factors with significant difference 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.


2021 ◽  
Vol 6 (1) ◽  
pp. 27-31
Author(s):  
S. D. Babazhanova ◽  
A. S. Lyubchich ◽  
Yu. K. Jabbarova

Aim. To determine the factors contributing to maternal death due to preeclampsia.Materials and Methods. We performed a retrospective study of 149 maternal deaths from preeclampsia during 2013-2017, which included the analysis of birth histories, medical records, individual observation cards, outpatient records, and questionnaires of healthcare workers and relatives.Results. Preeclampsia was responsible for 24.1% of maternal deaths over 5 years (2013-2017). The causes of death in women with preeclampsia were: pulmonary oedema (33/149, 22.2% cases), acute renal failure (33/149, 22.2%), cerebral complications (43/149, 28.6%), and hepatic impairment (acute fatty liver of pregnancy or HELLP syndrome, 45/149, 30.2%). The majority of pregnant women admitted in critical condition because of acute fatty liver of pregnancy or HELLP syndrome (45/149, 30.2%), eclampsia at home (25/149, 16.8%), or severe hypertension (114/149, 76.5%). The majority of those who died from preeclampsia had premature births (86/149, 57.7%) and delivered by caesarean section (117, 78.5%), yet the latter was associated with a higher risk of maternal death in case of preeclampsia (OR = 30.028. 95% CI = 15.277-59.022) as compared with vaginal delivery. Risk factors of the maternal death in preeclampsia included late hospitalization (66% of deaths), inadequate antenatal care (64.4%), incorrect route of examination and hospitalization (31.6%), underestimation of the patient's condition (42.3 %), insufficient monitoring during pregnancy, childbirth and post childbirth (48.8%), and insufficient teamwork of medical staff (42.2%).Conclusions. Insufficient knowledge of preeclampsia symptoms by pregnant women and their families, insufficient monitoring of blood pressure, underestimation of organ dysfunction, late hospital admission, late delivery, insufficient antihypertensive therapy, delivery at elevated blood pressure, and insufficient teamwork of healthcare professionals increase the risk of maternal mortality in the patients with preeclampsia.


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