A Rare Disease Presenting Postpartum: Acute Fatty Liver of Pregnancy.

IF 0.6 Q4 OBSTETRICS & GYNECOLOGY
Case Reports in Obstetrics and Gynecology Pub Date : 2021-09-30 eCollection Date: 2021-01-01 DOI:10.1155/2021/1143470
Sofía Córdoba-Vives, Patricia Pérez-Rodríguez, Astrid Marín-Delgado, Miguel Matus-Vargas, Adriana Arias-González
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Abstract

Acute fatty liver of pregnancy is a rare but highly fatal disease affecting women most frequently during the third trimester of pregnancy or in the postpartum period. It is considered a diagnosis of exclusion and requires a timely diagnosis to avoid maternal mortality. We present the case of a 33-year-old primigravida who required an emergency cesarean section due to fetal bradycardia. On postoperative day one, the patient was noted jaundiced, oliguric, and hypoglycemic. Laboratory tests revealed important hepatic dysfunction, coagulopathy, and renal failure. She was admitted to the Intensive Care Unit with the suspicion of acute fatty liver of pregnancy. Plasma exchange was started on postoperative day 5 with major clinical and laboratory improvement. A transjugular hepatic biopsy confirmed the diagnosis. The patient had satisfactory evolution and was discharged 15 days after delivery. Acute fatty liver of pregnancy is a highly morbid disease that needs a high index of suspicion to be diagnosed. Admission to an Intensive Care Unit to ensure maximum supportive care is mandatory in this disease.

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产后出现的罕见疾病:妊娠急性脂肪肝。
妊娠急性脂肪肝是一种罕见但极易致命的疾病,多发于妊娠三个月或产后的妇女。它被认为是一种排除性诊断,需要及时诊断以避免孕产妇死亡。我们报告了一例 33 岁初产妇因胎儿心动过缓而需要紧急剖宫产的病例。术后第一天,患者出现黄疸、少尿和低血糖。实验室检查显示她出现了严重的肝功能异常、凝血功能障碍和肾功能衰竭。由于怀疑是妊娠急性脂肪肝,她被送进了重症监护室。术后第 5 天开始进行血浆置换,临床和实验室检查均有明显改善。经颈静脉肝活检证实了诊断。患者的病情发展令人满意,并于产后 15 天出院。妊娠期急性脂肪肝是一种发病率很高的疾病,需要高度怀疑才能确诊。这种疾病必须入住重症监护病房,以确保最大程度的支持性护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Case Reports in Obstetrics and Gynecology
Case Reports in Obstetrics and Gynecology Medicine-Obstetrics and Gynecology
CiteScore
1.30
自引率
0.00%
发文量
64
审稿时长
12 weeks
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