Acute fatty liver of pregnancy in Shenzhen: incidence, clinical features and prognosis

Abstract

Objective To identify the incidence, clinical features and prognosis of acute fatty liver of pregnancy (AFLP). Methods The clinical data of AFLP from all hospitals in Shenzhen, China in the past 8 years were collected. The incidence, clinical characteristics and outcomes of AFLP were analyzed. Results There were 982 761 pregnant women from 2003 to 2010 and 44 of them were diagnosed as AFLP. The incidence of AFLP was 1/22 335. In this cohort of 44 cases with AFLP, 23 patients complicated by gestational hypertension disease, and the incidence was 52%. The mean (SD)maternal age was (27.7±5.7) and the gestational age at onset was 30+ 2-40+ 3 weeks. Thirty-three cases (75%) of them were primipara and 9 cases (20%) were multiple pregnancies. The first symptom was gastrointestinal symptoms 37 cases (84%), aggravated jaundice 40 cases (91%), coagulopathy 39 cases (89%), hepatorenal syndrome 25 cases (57%), hepatic encephalopathy 9 cases (20%), and multi-organ dysfunction syndrome 5 cases (11%). Thirty-nine cases were cured while 5 women died. The maternal mortality was 11%. The fetal outcomes showed 45 livinginfants, 9 fetuses death, and 1 neonatal death. The prenatal mortality was 18%. Conclusions The first symptom of AFLP was gastrointestinal symptoms in late pregnancy and the AFLP was associated with jaundice, high liver enzymes, coagulopathy, and early-onset acute renal failure. Early diagnosis and timely terminating pregnancy may improve the outcomes. Key words: Pregnancy; Fatty live; Incidence