Back كبد دهني حاد أثناء الحمل Arabic כבד שומני בהריון HE 急性妊娠脂肪肝 Japanese Ostre stłuszczenie wątroby ciężarnych Polish Fígado gorduroso da gravidez Portuguese Острая жировая дистрофия печени у беременных Russian
| Acute fatty liver of pregnancy | |
|---|---|
| Specialty | Obstetrics, Perinatology, Hepatology |
| Complications | Death, Disseminated intravascular coagulation |
| Usual onset | Third trimester of pregnancy |
| Causes | Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency |
| Diagnostic method | Clinical history and physical examination Liver biopsy (rarely needed) |
| Treatment | Prompt delivery of the infant, Intensive supportive care Liver transplantation |
| Frequency | 1 in 7,000 to 1 in 15,000 pregnancies |
| Deaths | 18%[1] |
Acute fatty liver of pregnancy is a rare life-threatening complication of pregnancy that occurs in the third trimester or the immediate period after delivery.[1] It is thought to be caused by a disordered metabolism of fatty acids by mitochondria in the fetus, caused by long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency.[2] This leads to decreased metabolism of long chain fatty acids by the feto-placental unit, causing subsequent rise in hepatotoxic fatty acids in maternal plasma. The condition was previously thought to be universally fatal,[3] but aggressive treatment by stabilizing the mother with intravenous fluids and blood products in anticipation of early delivery has improved prognosis.[4]
- ^ a b Ko H, Yoshida EM (2006). "Acute fatty liver of pregnancy". Canadian Journal of Gastroenterology. 20 (1): 25–30. doi:10.1155/2006/638131. PMC 2538964. PMID 16432556.
- ^ Bellig LL (2004). "Maternal acute fatty liver of pregnancy and the associated risk for long-chain 3-hydroxyacyl-coenzyme a dehydrogenase (LCHAD) deficiency in infants". Advances in Neonatal Care. 4 (1): 26–32. doi:10.1016/j.adnc.2003.12.001. PMID 14988877. S2CID 29356240.
- ^ Mjahed K, Charra B, Hamoudi D, Noun M, Barrou L (2006). "Acute fatty liver of pregnancy". Archives of Gynecology and Obstetrics. 274 (6): 349–353. doi:10.1007/s00404-006-0203-6. PMID 16868757. S2CID 24784165.
- ^ Riely CA (1999). "Liver disease in the pregnant patient. American College of Gastroenterology". The American Journal of Gastroenterology. 94 (7): 1728–1732. doi:10.1111/j.1572-0241.1999.01199.x. PMID 10406228. S2CID 36694459.