Bacq Y, Constans T, Body G, Choutet P, Lamisse F
J Gynecol Obstet Biol Reprod (Paris). 1986;15(7):851-61.
The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed.
作者分析了115例经组织学证实的妊娠急性脂肪肝病例。该病的特征是在含有微泡状脂滴的肝细胞中发现中央核。此病在初产妇中更为常见（54%），通常发生在妊娠晚期。黄疸出现前常有黄疸前期，在此期间通常有呕吐和/或恶心伴腹痛或食欲不振。92%的病例会出现肝性脑病导致的短暂意识丧失。进一步检查表明，肝功能损害程度比预期的细胞溶解程度更严重；且存在肾功能损害。最严重的并发症是肠道出血（48%的病例）、生殖道出血（43%的病例）、休克、弥散性血管内凝血以及与昏迷相关的并发症。目前孕产妇死亡率为25%，胎儿死亡率为60%。此病不会复发。大多数作者建议尽早排空子宫，这可能会改善预后。文中讨论了关于病因的各种假说。
