Acute fatty liver of pregnancy: Retrospective analysis

Yıl 2003, Cilt: 34 Sayı: 1, 1 - 6, 01.02.2003

Selçuk Arslan Önder Koç Ümmügülsüm Koç Görkem Tuncay

Öz

Objective: Our purpose was to investigate the diagnostic problems and to assess maternal and perinatal outcome in cases of fatty liver of pregnancy. Material and method : Eight cases with acute fatty liver of pregnancy managed during the past two years were studied with emphasis on presenting symptoms, admitting diagnosis, laboratory findings,clinical course, maternal complications and neonatal outcome. Results: The mean gestational age at onset was 34 weeks (range 31-40) Only two patients had acute fatty liver of pregnancy as a definite or suspected diagnosis on admission. Computed tomography and ultrasonography of the liver was performed on five patients .We performed liver biopsy other three patients. There was one maternal death, however,maternal morbidity was frequent. Two patients had hepatic ancep halopathy, three ascites ,and one renal failure. The corrected perinatal mortality was 142 in 1000. Conclusion: Acute fatty liver of pregnancy should be suspected in all patients with symptoms of preeclarnpsia in the presence of hypoglycemia, low fibrinogen and prolonged prothrombine time particularly in the absence of severe abruptio placenta In spite of the literature's dismal prognosis ,our findings indicate that maternal and perinatal outcomes appear favorable in well managed patients.

Anahtar Kelimeler

Retrospective Studies, Fatty Liver, Pregnancy, Pre-Eclampsia

Gebeliğin akut yağlı karaciğeri: Retrospektif analiz

Öz

Amaç : Gebeliğin akut yağlı karaciğeri olgularında, tanısal problemleri, gebeliklerin nasıl sonuçlandığını ve maternal mortaliteyi araştırmaktır. Materyal ve metod : Ocak 2000 - Mayıs 2002 tarihleri arasında, gebeliğin akut yağlı karaciğeri tanısı konulan 8 hasta, semptomları, yatış tanıları, laboratuar bulguları, klinik seyir, maternal komplikasyonlar ve yeni doğanın durumu gibi parametreler dikkate alınarak değerlendirildi. Sonuçlar : Semptomlar ortalama 34. Gebelik haftasında ( ranj 31-40 ) ortaya çıkmaktaydı. Hastalardan ikisinde ön tanı olarak gebeliğin akut yağlı karaciğeri düşünülmüştü. Üç hastada tanı karaciğer biopsisiyle kesinleştirilirken, 5 hastada tanı kompüterize tomografi veya ultrasonografi ile konuldu . Bir hasta ex olurken, iki hastada hepatik ansefalopati, üç hastada karında yaygın asit ve bir hastada renal yetmezlik saptandı. Düzeltilmiş perinatal mortalite binde 142 olarak hesaplandı. Tartışma: Şiddetli, plasenta dekolmanı olmayan, hipoglisemi, hipofibrinojenemi, uzamış protrombin zamanı saptanan preekamptik olgularda gebeliğin akut yağlı karaciğerinden şüphelenilmelidir. Literatürdeki çok sayıda kötü sonuçlanan gebeliğe rağmen, erken ve doğru yaklaşımla daha iyi sonuçlar elde edildi.

Anahtar Kelimeler

Geriyedönük çalışma, Yağlı karaciğer, Gebelik, Preeklampsi

Kaynakça

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