11/84. Acute fatty liver of pregnancy: a case report.The third trimester of pregnancy has several unique disease entities that challenge the anesthetist. Acute fatty liver of pregnancy (AFLP) is an increasingly recognized metabolic disorder found late in pregnancy. Current research estimates the incidence of AFLP at 1 per 6,659 births. Improved maternal morbidity and mortality is credited to early recognition and termination of the pregnancy. The decline in hepatic cellular activity is evident by the deterioration in metabolic, synthetic, and excretory functions of the liver. This obstetrical emergency can lead to death of both mother and child if not diagnosed in time to prevent coagulopathic complications.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
12/84. Lipid content in the liver of fatty metamorphosis of pregnancy.Lipid analyses were performed on the liver of a patient who died during an episode of acute fatty liver of pregnancy, and on livers from normal subjects and from subjects suffering from nutritional fatty livers. Comparison of these data indicates that in fatty liver of pregnancy the increased hepatic lipids consist primarily of free fatty acids. The recognized toxicity of fatty acids suggests a pathogenic mechanism for the disease. Nutritional fatty liver is associated predominantly with an increase in triglyceride. These changes are not the result of postmortem change, and they confirm and extend the previous data concerning the fat accumulation in human hepatic illness.- - - - - - - - - - ranking = 0.75keywords = pregnancy (Clic here for more details about this article) |
13/84. Acute fatty liver of pregnancy: a report of two cases.Acute fatty liver of pregnancy is an uncommon, potentially fatal disorder. Between 1998 and 2000, two patients with acute fatty liver of pregnancy presented at the Christian Medical College Hospital, Vellore. Both patients were in the thirty-sixth week of pregnancy. jaundice and encephalopathy were the predominant symptoms. Both the mothers died after they delivered a stillborn infant each. The maternal deaths were due to multiorgan failure and/or postpartum haemorrhage and sepsis. The route of delivery was vaginal in both the patients. Extrahepatic and metabolic complications in both cases Included renal failure, sepsis, hypoglycaemia, disseminated intravascular coagulation and gastrointestinal bleeding. Liver biopsy done in both patients was consistent with the diagnosis of acute fatty liver of pregnancy. To the best of our knowledge, this is the first report from india on acute fatty liver of pregnancy.- - - - - - - - - - ranking = 1.125keywords = pregnancy (Clic here for more details about this article) |
14/84. Acute fatty liver of pregnancy.Acute fatty liver of pregnancy can produce a great variety of complications. Of these, infections are important. We describe two cases, one of them complicated with uterine sepsis. Both gave evidence of the necessity for multidisciplinary treatment, which reduces the maternal-fetal morbidity and mortality produced by this disease.- - - - - - - - - - ranking = 0.625keywords = pregnancy (Clic here for more details about this article) |
15/84. Acute fatty liver in pregnancy.When confronted with liver abnormalities during the third trimester of pregnancy, one should consider acute fatty liver of pregnancy. The differential diagnosis with (pre-)eclampsia and hellp syndrome is sometimes difficult. In these cases a liver biopsy is helpful though rarely performed during pregnancy. After delivery of the child the liver test abnormalities will ultimately disappear. Recent publications reveal that a dysfunction in the beta-oxidation of mitochondrial fatty acids may contribute to the aetiology of this rare disorder. We describe a case of acute fatty liver in pregnancy, with liver dysfunction (decreased albumin, prolonged prothrombin time) slowly returning to normal after delivery. Testing for disorders in beta-oxidation of mitochondrial fatty acids did not reveal abnormalities in mother or child.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
16/84. Acute fatty liver of pregnancy: a case report a review of the literature.Acute fatty liver of pregnancy (AFLP), a rare and potentially fatal disease, usually affects a primi gravida during the third trimester of pregnancy. We report a case of AFLP with a favourable maternal outcome.- - - - - - - - - - ranking = 0.75keywords = pregnancy (Clic here for more details about this article) |
17/84. Maternal acute fatty liver of pregnancy and the associated risk for long-chain 3-hydroxyacyl-coenzyme a dehydrogenase (LCHAD) deficiency in infants.Acute fatty liver disease of pregnancy has been recognized as a clinical problem since the 1980s. In the past 8 years, the association of this disease with a genetic inborn error of metabolism in the infant has been recognized. women who are heterozygous for this disorder are usually asymptomatic until the capacity of their livers to metabolize free fatty acids (FFA) is overwhelmed by a homozygous fetus. The inborn error of metabolism, long-chain 3-hydroxyacyl-coenzyme a dehydrogenase (LCHAD) deficiency, may not be immediately recognizable in the infant. Symptoms in the infant are often triggered by an increased long-chain fatty acid load in the diet, or by illness that results in breakdown of endogenous fat. The following case study reviews the clinical pathophysiology of this perinatal health problem and highlights the priorities for the care of infants born to mothers with acute fatty liver disease of pregnancy.- - - - - - - - - - ranking = 0.75keywords = pregnancy (Clic here for more details about this article) |
18/84. Orthotopic liver transplantation for acute liver failure resulting from "acute fatty liver of pregnancy".Steatosis of the liver, demonstrating itself as the acute liver failure during the third trimester of pregnancy (Acute fatty liver of pregnancy--AFLP) is a rarely observed liver pathology. Herewith we describe the case of a 19-years old pregnant patient with this rare disease. The authors present the clinical course, dynamics, diagnostics, and outcome of treatment in this unique case. In this patient the ultimate treatment chosen was the liver transplantation. The opinions, concerning liver transplantation in AFLP (expressed in the world literature) are somewhat controversial. This paper presents the first case of AFLP treatment with orthotopic liver transplantation (OLTx) in poland.- - - - - - - - - - ranking = 0.625keywords = pregnancy (Clic here for more details about this article) |
19/84. Fulminant hepatic failure in a young mother.We report the case of a mother who developed fulminant hepatic failure with hypoglycaemia, coagulopathy, Grade III hepatic encephalopathy, two days after the delivery of her fourth child. She had complained of pruritus for the final two weeks of pregnancy. She received supportive medical management within a critical care unit, and the hepatic failure resolved completely within 48 hours. Liver biopsy confirmed the diagnosis of acute fatty liver of pregnancy. This case is unusual in that this patient deteriorated markedly following delivery, at a time when spontaneous recovery is normally expected.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
20/84. Transient remnant removal disease in acute fatty liver of pregnancy.OBJECTIVE: To elucidate the potential role of an altered lipid metabolism in the pathophysiology of acute fatty liver of pregnancy (AFLP). CASE REPORT: We report on two otherwise healthy women in the 34th gestational week who presented with symptoms of AFLP. Besides characteristic symptoms like nausea, abdominal pain, highly elevated serum amino transferase levels, and increased creatinine concentrations, the patients' clotting system showed consumption and/or decreased synthesis of coagulation factors. Pregnancies were terminated by elective cesarean section because of worsening symptoms. blood tests normalized quickly and both the mothers and their baby boys could be dismissed in healthy condition. STUDY DESIGN: blood samples were collected shortly before delivery and 5, 15, 70, and 110 days afterwards. lipids and apolipoproteins (apo) were analyzed in whole plasma as well as in very low density, intermediate density, low density (LDL), and high density lipoprotein. Total LDL was further separated into 6 LDL subfractions by equilibrium density ultracentrifugation. RESULTS: Before delivery, the LDL subfraction pattern was characterized by the virtual absence of intermediate and most dense LDL. Lipoprotein electrophoresis showed the presence of beta-migrating VLDL. Within days after delivery, the distribution of apoB-containing lipoproteins returned to normal. Genetic variations of apoE, lipoprotein lipases, and the long-chain 3-hydroxyacyl-coenzyme a dehydrogenase were not detected in any of the patients. CONCLUSIONS: The lipoprotein metabolism in the acute phase of AFLP was reminiscent of hepatic lipase deficiency, a disorder characterized by impaired removal of lipoprotein remnants. As these triglyceride-rich particles cause endothelial dysfunction, they may contribute to the pathophysiology of AFLP.- - - - - - - - - - ranking = 0.625keywords = pregnancy (Clic here for more details about this article) |
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