Acute fatty liver of pregnancy: a report of 25 cases

Abstract

To develop an optimal algorithm of early diagnostics of acute fatty liver of pregnancy (AFLP) an analysis was carried out of 25 prospectively detected cases of AFLP in 1985-1997 yrs. The age of patients was 21-40 years, among them 16 — nulliparas, 9 — multi paras.

Full Text

To develop an optimal algorithm of early diagnostics of acute fatty liver of pregnancy (AFLP) an analysis was carried out of 25 prospectively detected cases of AFLP in 1985-1997 yrs. The age of patients was 21-40 years, among them 16 — nulliparas, 9 — multi paras. Clinical and statistical analysis has shown that AFLP develops mainly at the gestational age of 28-30 weeks. Two phases in clinical manifestation has been detected: 1. Nonicteric phase with length till 8 weeks, characterized by weakness, headaches, dizzinesses, weight loss, pruritus, heartburn (with exception of gastrointestinal disorders). 2. Icteric phase, with severe clinical picture (duration - from 2-3 weeks to 1-2 days). Laboratory studies have shown a significant decrease of total serum protein, Hb and of platelet count, 2-10-fold increase of bilirubin and liver enzymes activity (AsAT, AlAT); hypocoagulation resulting in DIC. ECG has detected myocardial metabolic changes associated with right ventricle hypoxia and signs of its overload. The designed algorithm of early AFLP detection has promoted timely diagnosis and appropriate therapy. Only 2 women died. The rest are under thorough surveillance. The research is being continued.