General

Acute Fatty Liver of Pregnancy

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22 Jul 2016 - General
 

Acute fatty liver of pregnancy is a rare disorder in pregnancy, occur in 1 in 13000 to 16000 pregnancies. It can occur in second, or third trimester, occassionally postpartum. Patient will presented with jaundice, lethargy, nausea, vomitin, and altered mental status. Blood tests may show moderate ALT/AST elevations, conjugated hyperbilirubinemia, high PT, fibrin splits products, D-dimer, low platelet, high amonia level, serum uric acid and leukocytosis. In the severe situation, a rapid progress to hypoglcemia, disseminated intravascular coagulation, renal impairment, coma or death can occur. Anyone has any experience in this rare disorder in pregnancy ?? What are the management strategy ?


@Ziwei, intrahepatic cholestasis of pregnancy, is another different form of liver disease in pregnancy. This is the most common liver disease related to pregnancy. The main symptoms will be severe pruritis, onset in second or usually in the third trimester. The biochemical abnormalities will be increased in serum bile acid, increased in ALP, slight elevated AST, ALT, and GGT usually is normal. The symptom of pruritus is usually resolved after delivery of baby, but the biochemical abnormalit...
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I remembered having a woamn coming to me post partum for follow up for this condition. She has already been discharged and LFT on a downward trend. The purpose of the visit to me is to ensure that LFTs have returned to normal. As a minimum,my job is to ensure that LFTs return to normal,pruritus resolves,all investigations carried out during the pregnancy have been reviewed and the mother has fully understood the implications of obstetric cholestasis. The latter will include reassurance about the...
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