Case Report: Acute Fatty Liver of Pregnancy

Huynh Nguyen Khanh Trang,Hoang Thi Diem Tuyet

doi:10.4236/ojog.2017.710102

Huynh Nguyen Khanh Trang, Hoang Thi Diem Tuyet

Open Access

https://doi.org/10.4236/ojog.2017.710102

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Abstract

Acute fatty liver of pregnancy (AFLP) is a rare disease in Vietnam. Diagnosis by recorded literature is often difficult to distinguish from viral hepatitis, paraplegia, or bile duct disease, so AFLP diagnosis is often delayed. The prevalence of hepatitis B in Vietnam in pregnant women is estimated at 10% REF _Ref494526757 \r \h [1], preeclampsia is estimated at 0.2% REF _Ref494526760 \r \h [2]. A case pregnant woman has 35.5-week gestational age with AFLP, who was safely delivered both mother and infant at Hung Vuong hospital, Vietnam. A careful history and physical examination, in conjunction with compatible laboratory and ultrasound imaging results, are often sufficient to make the diagnosis, and liver biopsy is rarely indicated. Intensive adjuvant therapy and rapid birth control are essential for maternal and fetal outcomes.

Highlights

Acute fatty liver of pregnancy (AFLP) was first described in 1940 by Sheehan [3] “Acute hepatic jaundice”
The prevalence of hepatitis B in Vietnam in pregnant women is estimated at 10% [1], preeclampsia is estimated at 0.2% [2]
Studies have documented that long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) seems to be more susceptible to AFLP

Summary

Introduction

Acute fatty liver of pregnancy (AFLP) was first described in 1940 by Sheehan [3] “Acute hepatic jaundice”. Acute fatty liver is reported to be more common in twin than in singleton pregnancies. KM Davidson et al report three cases of biopsy-proven acute fatty liver in triplet gestations. In AFLP, there is a progressive accumulation of fat in the liver cells. In AFLP, this rate may increase from 13% to 19% [3] This fat accumulation, along with ammonia produced by hepatocytes, leads to coagulant dysfunction and secondary hypoglycaemia develops to liver failure [5] [9]. Analysed five consecutive cases of acute fatty liver of pregnancy, along with the associated morbidity, mortality and complications, pain on right side or epigastric area are usual symptoms [6]. Transient diarrhea may occur, but is rare [11] (Table 1)

Case Report

Discussion

Findings

Conclusion