| Abjective: To analyze the clinical characteristics and the effect on mother and fetus of 36 patients with acute fatty liver of pregnancy.Methods : We performed a retrospective study of 36 patients with AFLP between January 2012 and December 2015.We analyzed the clinical features,laboratory results,perioperative management,and patient outcomes.According to prothrombin activity(PTA),the 36 patients were divided into three groups:75%<PTA<100% for PTA normal group(group A),40%<PTA<75% for the light group(group B),PTA<40%group for the light group(group C).The complications of the three groups were statistical compared.Results: The onset gestational age was at the(35.99 ±2.31)th week,and most of them were primipara,and a majority of the child were male.The 36 cases of patients with acute fatty liver of pregnancy were significantly gastrointestinal symptoms.Liver-function indexes were remarkable,including elevated levels of serum alanine aminotransferase(298.72 ± 290.41 U/L)),aspartate aminotransferase(258.14 ± 223.56 U/L),lactic dehydrogenase(867.98±234.52 U/L),and direct bilirubin(79.86 ± 87.57 μmol/L).The coagulation had disorders,with the index of prothrombin time,D-dimer,fibrogen degradation pruducts increased and fibrogen,prothrombin activity reduced.In addition to the results above,uric acid,creatinine,white blood cell and lactate dehydrogenase were increased abnormally.,and the plate were reducd.Compared with group A,the cases of renal insufficiency,coagulation disorders,DIC,MODS and hypoalbuminemia in group B and group C had a statistical significance,Compared with group B,it had a statistical significance in the cases of renal insufficiency,coagulation disorders,DIC and hypoalbuminemia in group B.The main maternal complications were hypoproteinemia(55.6%),coagulopathy(58.3%),and acute renal failure(44.4%).Conclusions: Clinical symptoms,laboratory tests of creatinine and lactate dehydrogenase rise can be taken as reference indexes of the diagnosis of AFLP.Once diagnosed,pregnancy should be terminated,and multi-disciplinary integrated support treatment is the key to successful rescue.For PTA decreased patients,more attention should be paid to reduce the effect on both mother and fetus. |
