Patidar Rekha, Gowdra Revannasiddappa Krishi, Ghazanfer Muniza
Obstetrics and Gynecology, Zulekha Hospital, Dubai, ARE.
Cureus. 2024 Feb 9;16(2):e53911. doi: 10.7759/cureus.53911. eCollection 2024 Feb.
Acute fatty liver of pregnancy (AFLP) is a rare, potentially fatal obstetric emergency. Due to its nonspecific signs and symptoms, there is often a delay in diagnosis and management which is associated with morbid complications and high mortality. We report a case of a 30-year-old female gravida 3 para 2 at 32 weeks gestation who presented with nausea and vomiting for two weeks, pruritis for three days, and upper abdomen pain for a day. A clinical diagnosis of HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome/obstetric cholestasis/AFLP was made. Despite prompt management, her postpartum period was complicated by acute hepatic encephalopathy, hepatorenal shutdown, pancreatitis, coagulopathy, postpartum hemorrhage, and large abdominal wall hematoma. A high index of suspicion, prompt delivery, advanced critical support, and multidisciplinary team involvement led to successful fetomaternal outcomes in the patient.
妊娠急性脂肪肝（AFLP）是一种罕见的、可能致命的产科急症。由于其体征和症状不具特异性，诊断和治疗往往会延迟，这与严重并发症和高死亡率相关。我们报告一例30岁、孕3产2、妊娠32周的女性病例，该患者出现恶心、呕吐两周，瘙痒三天，上腹部疼痛一天。临床诊断为HELLP（溶血、肝酶升高和血小板减少）综合征/产科胆汁淤积症/AFLP。尽管进行了及时治疗，但其产后仍出现急性肝性脑病、肝肾衰竭、胰腺炎、凝血功能障碍、产后出血和腹壁巨大血肿等并发症。高度的怀疑指数、及时分娩、先进的重症支持以及多学科团队的参与使该患者母婴获得了成功结局。
