妊娠急性脂肪肝：病例报告。
Acute fatty liver of pregnancy: a case report.
机构信息
Department of Obstetrics and Gynaecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
Department of Histopathology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
出版信息
BMC Pregnancy Childbirth. 2019 Jul 22;19(1):259. doi: 10.1186/s12884-019-2405-5.
BACKGROUND
Acute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention.
CASE PRESENTATION
We report a case of AM, an 18 year patient, in her first pregnancy at 35 weeks gestation who presented with nausea, vomiting and jaundice. She had a vaginal delivery following spontaneous preterm labour. A clinical diagnosis of acute fatty liver of pregnancy was made on the 3rd day post-delivery. The post-delivery course was complicated by a deterioration of clinical symptoms with worsening hepatorenal function and development of encephalopathy. The patient died 3 days after admission and the diagnosis was confirmed on post-mortem and histology.
CONCLUSION
Delay in the diagnosis is associated with morbid complications with high mortality and this case highlights the importance of a high index of suspicion of the condition in women presenting with jaundice in pregnancy.
背景
妊娠急性脂肪肝（AFLP）是一种罕见的灾难性疾病，影响妊娠晚期或产后的妇女。它通常是一种排除性诊断，需要高度怀疑才能及时诊断和及时干预。
病例介绍
我们报告了一例 AM，一位 18 岁的首次妊娠患者，妊娠 35 周时出现恶心、呕吐和黄疸。她在自发性早产后行阴道分娩。产后第 3 天临床诊断为妊娠急性脂肪肝。产后病程复杂，临床症状恶化，肝肾功能恶化，并出现脑病。患者入院后 3 天死亡，尸检和组织学证实了诊断。
结论
诊断延迟与严重并发症相关，死亡率高，本例强调了对妊娠黄疸妇女出现这种情况的高度怀疑的重要性。
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