Re: fatty liver

Posted By HFHSM.D.-kb on March 13, 1998 at 07:32:35:

In Reply to: fatty liver posted by jill williams on February 28, 1998 at 10:36:20:







: I am looking for more information about acute fatty liver of pregnancy as I recently had a 3 day post-partum patient expire suddenly whose micro report from autopsy showed acute fatty liver as cause of death. Could you give me some information about this as i have not heard of it before. I was told by a resident that this condition is always fatal in a pregnant patient. thank you. Jill w. RN
_______


Dear Jill,
Acute fatty liver of prenancy is a pathologic entitiy unique to pregnancy and characterized by microvesicular fatty infiltration of the liver.  It can present as fulminent hepatic failure which is defined as the acute onset of encephalopathy within 8 weeks of diagnosis of liver disease in a patient with no prior history of liver dysfunction.  Preeclampsia often accompanies this and the disease may be a part of a spectrum seen in pregnant patients.  There is often overlap with other diagnoses including eclampsia and the HELLP syndrome.  Fetal loss is high.  Treatment is often supportive with early delivery of the baby recommended.  The syndrome usually presents in the third trimester but may present after delivery.   Etiology of this process is unknown.  
If you are interested in learning more about this subject, I suggest the following:
1.Bacq et al. J Gynecol Obstet Biol Reprod 15;851, 1986
2.Kaplan et al. N Engl J Med 313;367, 1985
3.Schiff, Leon. Diseases of the Liver. Seventh Edition, Volume 2, pp.1421-1423.    J.B.  Lippincott, 1993
HFHSM.D.-kb
keywords: acute fatty liver of pregnancy, hepatic failure
0.2