Acute fatty liver of pregnancy complicating acute respiratory distress syndrome: A case report with survival of mother and child.
- Author:
Seok Kyo SEO
1
;
Ju Youn HWANG
;
Hyun Joon LEE
;
Bo Wook KIM
;
Han Byoul CHO
;
Yong Hyun CHAE
;
Kyung SEO
;
Kook LEE
Author Information
1. Department of Obstetrics and Gynecology, Yong-Dong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. dr3431@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Acute fatty liver of pregnancy;
Acute respiratory distress syndrome;
Maternal and perinatal outcome;
Intensive supportive care
- MeSH:
Adult;
Alkaline Phosphatase;
Ammonia;
Amylases;
Bilirubin;
Blood Platelets;
Cesarean Section;
Child*;
Creatinine;
Diagnosis;
Disseminated Intravascular Coagulation;
Emergencies;
Fatty Liver*;
Female;
Fibrinogen;
Gastroesophageal Reflux;
Humans;
Infant;
Jaundice;
Lipase;
Male;
Mothers*;
Oliguria;
Pancreatitis;
Postpartum Period;
Pregnancy*;
Reference Values;
Respiratory Distress Syndrome, Adult*;
Ultrasonography;
Ventilators, Mechanical
- From:Korean Journal of Obstetrics and Gynecology
2006;49(3):674-681
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report our experience with the diagnostic, clinical and biochemical findings, complications and maternal-perinatal outcome in a case of acute fatty liver of pregnancy. A 31-year-old multipara presented herself at 35 weeks' gestation with general malaise, gastroesophageal reflux, jaundice, hepatorenal dysfunction and disseminated intravascular coagulation. An abdominal ultrasound revealed a mild fatty liver. A tentative diagnosis of acute fatty liver of pregnancy was made, and immediately a healthy male infant weighing 2330 gm was delivered by emergency cesarean section. On 1, 2 and 6 days after delivery, oliguria, acute respiratory distress syndrome and pancreatitis developed, respectively. Abnormal levels of AST/ALT, creatinine, fibrinogen, PT/PTT and platelet recovered to normal ranges 7-10 days after delivery. Serum amylase and lipase became normal 24 days after delivery with conservative treatment. Ventilator care for acute respiratory distress syndrome continued up to 49 days after delivery, when total bilirubin, ammonia, alkaline phosphatase, r-GT, and AST/ALT began to normalize. The discharge was recommended on the 88th postpartum day. Our result suggests that acute fatty liver of pregnancy can be diagnosed on the basis of clinical and laboratory findings. Prompt delivery, intensive supportive care and awareness of its complications can markedly improve maternal and perinatal outcome.
