India Institute of Medical Sciences, Rishikesh, India.
Pan Afr Med J. 2021 Dec 13;40:220. doi: 10.11604/pamj.2021.40.220.31324. eCollection 2021.
Acute fatty liver of pregnancy (AFLP) is characterised by acute liver failure that occurs most commonly in the third trimester of pregnancy. Emergent delivery of the foetus reverses liver failure in most cases. Rarely, termination of pregnancy may not reverse liver failure, and adjunct interventions may be required. Therapeutic plasma exchange (TPE) has been described in AFLP in very few reports. We describe a patient in whom liver failure and extrahepatic organ failure persisted four days after delivery. She underwent TPE for persistent liver failure which resulted in prompt clinical improvement. We propose that TPE be considered as a measure to salvage AFLP patients with liver failure that does not reverse after termination of pregnancy.
妊娠急性脂肪肝（AFLP）的特征是发生于妊娠晚期的急性肝衰竭。大多数情况下，胎儿的紧急分娩可逆转肝衰竭。极少数情况下，终止妊娠可能无法逆转肝衰竭，可能需要辅助干预。极少量报告中曾描述过 AFLP 中采用治疗性血浆置换（TPE）。我们报告了 1 例患者，其分娩后 4 天持续存在肝衰竭和肝外器官衰竭。她因持续的肝衰竭而行 TPE，结果临床状况迅速改善。我们建议，对于终止妊娠后仍未逆转的肝衰竭的 AFLP 患者，可考虑采用 TPE 作为挽救措施。
