Acute fatty liver in pregnancy

The cause of this disease, acute fatty liver during pregnancy, is the fat adhesion in the liver caused by protein metabolism disorders and abnormal fatty acid metabolism during pregnancy. This acute fatty liver during pregnancy has a relatively large impact on the fetus and the pregnant woman's body. If it is treated well, the pregnancy must be stopped before treatment can be carried out. This is also the most important reason that affects pregnant women.

Causes of Acute Fatty Liver of Pregnancy

At present, the cause of acute fatty liver of pregnancy is uncertain, but because there is only a chance of recovery if the pregnancy is terminated, it is generally believed that the hormonal changes caused by pregnancy lead to fatty acid metabolism disorders, causing free fatty acids to accumulate in liver cells and other organs such as kidneys, pancreas, and brain, causing multiple organ damage.

There are varying degrees of protein metabolism disorders, certain amino acid deficiencies, and lipoprotein deficiencies in the late pregnancy, all of which can promote fatty degeneration and fat deposition in hepatocytes.

The damaging effects of viral infection, poisoning, drugs (such as tetracycline), malnutrition, and hypertensive disorders complicating pregnancy on mitochondrial fatty acid oxidation may also be related to this.

The pathological changes of AFLP are that the liver is normal in size or slightly reduced in size, yellow in color, soft and smooth, and has a greasy cross-section.

Treatment of acute fatty liver of pregnancy

Acute fatty liver of pregnancy has a great impact on mother and child. There is no specific treatment. Once diagnosed, the pregnancy should be terminated as soon as possible, and cesarean section or induced labor can be chosen. Symptomatic treatment should also be taken.

1. General treatment

Rest in bed, give a low-fat, low-protein, high-carbohydrate diet, ensure sufficient calories, and give intravenous glucose to correct hypoglycemia; pay attention to water and electrolyte balance and correct acidosis.

2. Exchange transfusion or plasma exchange

Plasma exchange therapy can remove irritating factors in the blood, supplement the coagulation factors that are lacking in the body, reduce platelet aggregation, and promote vascular endothelial repair. This treatment method is widely used abroad and has achieved good results.

3. Blood component transfusion

Treatment with large amounts of frozen fresh plasma can achieve similar effects to plasma exchange therapy. Red blood cells, platelets, human albumin, fresh blood, etc. can be given according to the situation.

4. Others

Patients with ascites should be treated with albumin, diuretics and paracentesis. When accompanied by hepatic encephalopathy, protein intake should be restricted and relevant drugs should be given. At the same time, DIC, pancreatitis, gastrointestinal bleeding, etc. should be actively treated.

5. Obstetric treatment

Once AFLP is confirmed or highly suspected, the pregnancy should be terminated as soon as possible regardless of the severity or early onset of the disease.