Acute fatty liver of pregnancy, called AFLP, is one of the
rare but serious diseases that occur during pregnancy. It can be seen in the
postpartum period, especially after the 30th week of pregnancy, or rarely after
birth. It is a rare condition seen in approximately 10-15 thousand pregnancies.
It is more common in twin pregnancies, first pregnancies and pregnancies where
the baby is a boy.
Symptoms:
Symptoms such as weakness, fatigue, jaundice, itching,
nausea, and abdominal pain can be seen. If the disease is severe, complications
that may endanger maternal life may develop. Maternal mortality changes around
10%, fetal mortality changes around 20%. Gastrointestinal bleeding may occur
due to coagulation disorder. Preterm labor occurs around 70%.
Results:
- Hypofibrinogenemia
- Hypoalbuminemia
- Hypocholesterolemia
- Hypoglycaemia
- Elongation at coagulation, coagulopathy
- Hepatic encephalopathy
- Serum transaminase height
- Hemolysis
- Proteinuria
- Kidney failure
- Encephalopathy
- DIC
Diagnosis:
Increased liver enzymes such as ALT and AST are detected.
Levels of bilurib increase. The production of clotting factors is disturbed due
to damage to the liver, and coagulation disorder may occur. Thrombocytopenia is
common. Impairment of kidney function tests may occur. Elongation occurs in
prothrombin time. Blood pressure may rarely occur, usually blood pressure is
normal. In some patients, acid due to portal hypertension may occur.
Hypoglycaemia may occur.
It is monitored by ultrasound that there is fat in the liver.
Fatty is also observed in liver biopsy, but liver biopsy cannot be performed in
patients with clotting disorders. Biopsy is not always necessary for diagnosis.
It does not mean that every pregnant woman with fatty liver is "acute
fatty liver of pregnancy". Fatty liver may develop due to other reasons.
Differential diagnosis should be made with other liver
diseases such as hepatitis and HELLP syndrome.
Treatment:
Since the acute fatty liver of pregnancy is a rapidly decreasing
disease after delivery, it is generally preferred to terminate the pregnancy
with birth as soon as possible. Therefore, it often causes premature birth.
Normal delivery may also be possible in cases where labor can occur rapidly or
start spontaneously, but cesarean is often required for urgent delivery.
Treatments for blood transfusion and correction of coagulation are often
required. There may be a risk of excessive bleeding during delivery due to
coagulation disorder.
-PREGNANCY DEPRESSION
-INTRAHEPATIC CHOLESTASIS OF PREGNANCY
-PREGNANCY AND EPILEPSY
-ECLAMPSIA
-PREGNANCY AND HEART DISEASES
-PREGNANCY AND SYSTEMIC LUPUS ERYTHEMATOSUS
