Гостра жирова дистрофія печінки вагітних, ускладнена абдомінальним компартмент- і ДВЗ-синдромами (Випадок із практики)

Abstract

The problem of late preeclampsia still remains its relevance today, considering the variety of possible severe complications of this obstetric pathology. In this context, acute fatty liver of pregnancy (AFLP) is considered as one of the most challenging complications of severe preeclampsia (or as a separate nosology) [frequency: 1 case per 7–16 thousand deliveries], which can possibly lead to the development of abdominal compartment syndrome (ACS) and coagulopathic changes. This complications combination is currently potentially fatal for the pregnant woman or those in labor and remains an urgent call for perinatologists. The article presents modern ideas about the etiology, diagnosis, treatment and delivery in case of this obstetric pathology on the example of an experienced clinical case. The aim of the study is to research the potential algorithm for AFLP diagnosis and treatment with analysis of the effectiveness of measures proposed. At the first stage, a retrospective review of publications on this issue was conducted with further analysis of the case of AFLP complicated by ACS and DIC syndrome, which was successfully conducted at the Department of Obstetrics and Gynecology №1. Successful outcome and recovery of a patient in a very serious condition was achieved with to the use of a basic algorithm of actions with delivery of a pregnant woman with AFLP, complex post-syndrome therapy of multiple organ failure, ACS surgical treatment, extraordinary approach to generalized fibrinolysis treatment, therapy with transfusion of whole single-group donor blood. Keywords: preeclampsia, acute fatty liver of pregnancy, abdominal compartment syndrome, DIC syndrome, hepato-renal dysfunction.