@rahat2021
Acute Fatty Liver of Pregnancy (AFLP)
Overview
• Etiology: AFLP is a rare but serious liver disorder that typically occurs in the third trimester of pregnancy. It is believed to be related to a defect in the mitochondrial beta-oxidation of fatty acids, often associated with a deficiency in the enzyme long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD).
• Incidence: AFLP affects approximately 1 in 7,000 to 1 in 20,000 pregnancies.
Clinical Presentation
• Symptoms: Nausea, vomiting, abdominal pain, jaundice, malaise, headache, and confusion. Symptoms can progress rapidly.
• Signs: Jaundice, hepatomegaly, ascites, encephalopathy, coagulopathy, hypoglycemia, renal dysfunction.
• Diagnosis: Elevated liver enzymes (AST, ALT), elevated bilirubin, prolonged prothrombin time (PT), hypoglycemia, elevated ammonia, and leukocytosis. Imaging and liver biopsy may show microvesicular steatosis.
Management
• Immediate Delivery: Prompt delivery of the baby, regardless of gestational age, is the definitive treatment.
• Supportive Care: Intensive monitoring and supportive care, including management of coagulopathy, hypoglycemia, and renal dysfunction.
• Prognosis: With early recognition and prompt delivery, maternal and fetal outcomes can be significantly improved. However, it can be fatal if not promptly treated.
• Playlist
RU-vid channel
/ @rahatq2021
Hi, This RU-vid channel has been created to help postgraduate trainees in Obstetrics and Gynecology learn and develop clinical skills for history taking, communication, counselling, quality assurance, critical reading of the literature.
3 авг 2024
