Introduction: Acute fatty liver of pregnancy (AFLP) is a rare obstetric emergency requiring immediate attention and intensive care to avoid adverse outcomes for the mother and fetus. High morbidity and mortality are seen among women with AFLP. As this condition poses many complications and is varied in its clinical presentation, the perinatal outcomes in women diagnosed with AFLP were studied.
Materials and Methods: This was a retrospective study that
involved all patients over the past 6 years who presented with AFLP. Clinical
signs and other altered biochemical parameters were included.
Results: In the study, 19 women were diagnosed to have AFLP. The
mean age of the study population was 25.74±3.7 years. 14 ( 73.68% ) women were
below the age of 30 years. A gestational age of more than 37 weeks was seen in
13 ( 68.42% ) women. Ten primigravidae ( 52.63% ) and nine multiparous (47.3%)
women were found to present with AFLP. The mean blood loss at the time of
delivery for a lower-section cesarian section and vaginal delivery was
787.5±494.07 mL and 280±44.72 mL, respectively. The preferred treatment at the
time of admission was transfusion of fresh frozen plasma (FFP) (Mean: 7.00±9
pints), followed by transfusion of platelet (Mean: 2.37±3.515 pints), transfusion
of packed red blood cells (Mean: 2.21±3.691 pints) and cryoprecipitate (Mean:
0.0±2 pints). Nine ( 47.37% ) women were delivered through emergency lower
segment cesarean section (LSCS) and all 4 (21.05%) pregnant women who succumbed
to AFLP underwent an LSCS. Among the newborns, 13 (65%) of them were low birth
weight and 2 (10.53%) had fetal distress.
Conclusion: This study showed a higher maternal mortality rate of
21% in comparison to other studies. Health professionals should be sensitized
about this condition and the use of the existing scoring system available to
help in detecting AFLP at an early stage to reduce maternal mortality and
adverse fetal outcomes. Blood loss at the time of delivery makes it imminent to
arrange for appropriate treatment and supportive care in the management of the
patient, which includes fresh frozen plasma transfusion which was found
beneficial in the patients.
Author
(s) Details
Christy Vijay
Department of Obstetrics and Gynecology, St. John’s Medical College and
Hospital, Bengaluru, Karnataka, India.
Annamma Thomas
Department of Obstetrics and Gynecology, St. John’s Medical College and
Hospital, Bengaluru, Karnataka, India.
Angeline Yvette
Mascarenhas
Department of Emergency Medicine, St. John’s Medical College and Hospital,
Bengaluru, Karnataka, India.
Naveen Ramesh
Department of Community Medicine, St. John’s Medical College and Hospital,
Bengaluru, Karnataka, India.
Please see the book here:- https://doi.org/10.9734/bpi/acmms/v13/4088
