medigraphic.com
ISSN 2007-8013 (Print)
Órgano oficial de la Universidad Autónoma de Sinaloa

2023, Number 4

<< Back Next >>

Rev Med UAS 2023; 13 (4)

Acute Fatty Liver in Pregnancy, a Potentially Fatal Entity: Clinical Case Report

Castro-Apodaca FJ, Uriarte-Valenzuela JÁ, Murillo-Llanes J, Magaña-Ordorica D, Peña-García GM, Téran-Cabanillas E, Sandoval-Quiñonez PA, Favela-Heredia CE, Rivas-Loaiza M, Morgan-Ortiz F, Heusinkveld JM

Language: Spanish
References: 16
Page: 404-411
PDF size: 191.13 Kb.


ABSTRACT

Acute fatty liver of pregnancy (AHFG) is a pathology characterized by hepatic infiltration of fatty acids, presenting suddenly during pregnancy, and is considered a potentially fatal obstetric emergency. The case of a 13-year-old primigravida is presented, who came for evaluation with labor, the ultrasound scan reported a single live product with risk of loss of fetal well-being, it was decided to terminate the pregnancy by cesarean section, during the intraoperative period, laboratories were collected and the diagnosis of HGAE was integrated according to Swansea criteria, so the patient was admitted to the obstetric intensive care unit.
Conclusions: HGAE is rare and resembles other liver diseases associated with pregnancy, such as preeclampsia with severity criteria, HELLP syndrome, intrahepatic cholestasis and hepatitis of viral, autoimmune and toxic origin. The diagnosis is made according to the Swansea criteria.


REFERENCES

  1. Ye R, Mai Z, Pan X, Cai S, Deng L. Acute fatty liverof pregnancy causes severe acute pancreatitis andstillborn fetus: A case report. Medicine. 2021;23;100(16):e25524. doi:10.1097/MD.0000000000025524.

  2. Naoum EE, Leffert LR, Chitilian HV, Gray KJ,Bateman BT. Acute Fatty Liver of Pregnancy:Pathophysiology, Anesthetic Implications, andObstetrical Management. Anesthesiology.2019;130(3):446-461. doi:10.1097/ALN.0000000000002597.

  3. Tran TT, Ahn J, Reau NS. ACG Clinical Guideline:Liver Disease and Pregnancy. Am J Gastroenterol.2016;111(2):176-94; quiz 196. doi:10.1038/ajg.2015.430.

  4. de Vasconcelos-Gaspar A, Ascensão TC, Santos-Silva I. Acute Fatty Liver of Pregnancy: Rare, butPotentially Fatal. Am J Case Rep. 2020;29;21:e921122. doi: 10.12659/AJCR.921122.

  5. Night M, Nelson-Piercy C, Kurinczuk JJ, Spark P,Brocklehurst P; UK Obstetric Surveillance System.A prospective national study of acute fatty liver ofpregnancy in the UK. Gut. 2008;57(7):951-6.doi:10.1136/gut.2008.148676.

  6. Knight M, Nelson-Piercy C, Kurinczuk JJ, Spark P,Brocklehurst P; UK Obstetric Surveillance System.A prospective national study of acute fatty liver ofpregnancy in the UK. Gut. 2008;57(7):951-6. doi:10.1136/gut.2008.148676.

  7. Châtel P, Ronot M, Roux O, Bedossa P, Vilgrain V,Bernuau J, ety al. Transient excess of liver fatdetected by magnetic resonance imaging inwomen with acute fatty liver of pregnancy. Am JObstet Gynecol 2016;214(1):127-9, doi:10.1016/j.ajog.2015.09.067.

  8. Kushner T, Tholey D, Dodge J, Saberi B, SchianoT, Terrault N. Outcomes of liver transplantation foracute fatty liver disease of pregnancy. Am JTransplant. 2019;19(7):2101-2107. doi:10.1111/ajt.15401.

  9. Lee NM, Brady CW. Liver disease in pregnancy.World J Gastroenterol. 2009;15(8):897-906. doi:

  10. 10.3748/wjg.15.897.10. Eduardo-Pino EN, Viruez-Soto JA, Aliaga-AguilarMA, Ávila-Hilari Ad, Zavala-Barrios B, Briones-Garduño JC et al. Hígado graso agudo delembarazo. Cuad. Hosp. Clín.2016;57(2): 45-50

  11. Morton A. Acute Fatty Liver of Pregnancy-Differential Diagnosis. Am J Gastroenterol.2017;112(8):1342. doi: 10.1038/ajg.2017.133.

  12. Santana-Cabrera L, Hernández-Medina E,O'Shanahan-Navarro G, Sánchez-Palacios M.Fallo multiorgánico secundario a hígado grasoagudo del embarazo. Med Intensiva.2006;30(2):81. doi: 10.1016/s0210-5691(06)74474-6.

  13. Tran TT, Ahn J, Reau NS. ACG Clinical Guideline:Liver Disease and Pregnancy. Am J Gastroenterol.2016 Feb;111(2):176-94; quiz 196. doi:10.1038/ajg.2015.430.

  14. Bellig LL. Maternal acute fatty liver of pregnancyand the associated risk for long-chain 3-hydroxyacyl coenzyme a dehydrogenase (LCHAD)deficiency in infants. Adv Neonatal Care.2004;4(1):26-32. oi: 10.1016/j.adnc.2003.12.001.

  15. Westbrook RH, Dusheiko G, Williamson C.Pregnancy and liver disease. J Hepatol.2016;64(4):933-45. doi:10.1016/j.jhep.2015.11.030.

  16. Goel A, Ramakrishna B, Zachariah U,Ramachandran J, Eapen CE, Kurian G, ChandyG. How accurate are the Swansea criteria todiagnose acute fatty liver of pregnancy inpredicting hepatic microvesicular steatosis? Gut.2011;60(1):138-9. doi: 10.1136/gut.2009.198465.




2020     |     www.medigraphic.com