555 results match your criteria Acute Fatty Liver of Pregnancy


Acute Fatty Liver of Pregnancy: Pathophysiology, Anesthetic Implications, and Obstetrical Management.

Anesthesiology 2019 Mar;130(3):446-461

From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (E.E.N., L.R.L., H.V.C.) the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine (K.J.G.) the Department of Anesthesiology, Perioperative and Pain Medicine (B.T.B.) the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine (B.T.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

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http://dx.doi.org/10.1097/ALN.0000000000002597DOI Listing
March 2019
1 Read

[Acute fatty liver of pregnancy].

Ned Tijdschr Geneeskd 2019 Jan 14;162. Epub 2019 Jan 14.

Ziekenhuis Gelderse Vallei, afd. Gynaecologie & Verloskunde, Ede.

Background: Acute fatty liver of pregnancy (AFLP) is a rare complication of pregnancy which is potentially fatal to mother and child.

Case Description: A primigravida at term with gestational diabetes presented at hospital complaining mainly of nausea and vomiting. Test results were consistent with acute fatty liver of pregnancy (AFLP). Read More

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January 2019
5 Reads

Immune thrombocytopenic purpura presenting with spontaneous gingival haemorrhage in pregnancy.

BMJ Case Rep 2019 Jan 17;12(1). Epub 2019 Jan 17.

Department of Oral and Maxillofacial Surgery, The Queen Elizabeth Hospital, Birmingham, UK.

Gingival bleeding is a common intraoral finding, typically associated with inflamed tissues and periodontal disease. It is easily provoked by periodontal probing or toothbrushing. Spontaneous gingival bleeding rarely occurs and may be the only sign of systemic bleeding problems such as thrombocytopenia, leukaemia or coagulopathy. Read More

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http://dx.doi.org/10.1136/bcr-2018-228309DOI Listing
January 2019
9 Reads

Acute fatty liver of pregnancy and concomitant medical conditions: A review of cases at a quaternary obstetric hospital.

Obstet Med 2018 Dec 5;11(4):178-181. Epub 2018 Jun 5.

Faculty of Medicine, University of Queensland, Brisbane, Australia.

Acute fatty liver of pregnancy is a rare complication of pregnancy that may result in fulminant hepatic failure. We present a review of all patients presenting to a quaternary obstetric hospital over a 15-year period, with particular regard to biochemical changes, results of gene testing, and pre-existing conditions. Seventeen patients with acute fatty liver of pregnancy were identified. Read More

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http://dx.doi.org/10.1177/1753495X18764816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295769PMC
December 2018
2 Reads

Readiness, Recognition, Response, and Reporting in a Case of Acute Fatty Liver of Pregnancy.

Authors:
Jane Ciaramella

Nurs Womens Health 2018 Dec 28;22(6):481-488. Epub 2018 Oct 28.

Acute fatty liver of pregnancy (AFLP) occurs less frequently than similarly challenging complications in pregnancy. Early recognition is key to reduce morbidity and mortality. Women present with symptoms common to many illnesses, and AFLP typically occurs in the third trimester. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17514851183019
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http://dx.doi.org/10.1016/j.nwh.2018.09.003DOI Listing
December 2018
12 Reads

A successful use of therapeutic plasma exchange in a fulminant form of acute fatty liver of pregnancy.

J Gynecol Obstet Hum Reprod 2019 Feb 11;48(2):133-137. Epub 2018 Oct 11.

Department of Anesthesia & Intensive Care Medicine, Medical School of Marrakech (Cadi Ayyad University), Mother & Child Hospital, Mohammed VI Teaching Hospital, Marrakech, Morocco.

Acute fatty liver of pregnancy (AFLP) continues to raise special concerns since its first post-mortem description by Sheehan in 1940. While early diagnosis and expedite delivery are the cornerstone of management, this condition remains fatal for both mother and fetus. Acute fulminant liver failure is the most serious and life-threatening AFLP-related complication and can require liver transplant despite aggressive supportive management. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S24687847183024
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http://dx.doi.org/10.1016/j.jogoh.2018.10.001DOI Listing
February 2019
4 Reads

Treating acute fatty liver of pregnancy with artificial liver support therapy: Systematic review.

Medicine (Baltimore) 2018 Sep;97(38):e12473

Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University.

Background: Acute fatty liver of pregnancy (AFLP) is a serious disease with high mortality. Recent data suggest that postpartum application of artificial liver support therapy (ALST) in AFLP management improves disease outcome. In current study, we tend to further evaluate whether the type, the timing, and the number of postpartum ALST sessions and other clinical factors including complications and liver and renal function will influence disease outcome in ALST era. Read More

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http://dx.doi.org/10.1097/MD.0000000000012473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160087PMC
September 2018
5 Reads

Acute fatty liver of pregnancy in a woman with ulcerative colitis and familial hidradenitis suppurativa.

Authors:
Adam Morton

Obstet Med 2018 Sep 19;11(3):141-143. Epub 2017 Nov 19.

Obstetric Medicine, University of Queensland, Queensland, Australia.

Acute fatty liver of pregnancy is a heterogeneous disorder which may occur in the absence of a detectable gene mutation for the enzyme long-chain L-3-hydroxyacyl-CoA dehydrogenase. Acute fatty liver of pregnancy has been reported to complicate several gastrointestinal disorders including viral hepatitis, chronic active hepatitis and intrahepatic cholestasis of pregnancy. A case of acute fatty liver of pregnancy in a woman with ulcerative colitis and familial hidradenitis suppurativa without a detectable gene mutation is presented. Read More

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http://dx.doi.org/10.1177/1753495X17736716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134355PMC
September 2018
3 Reads

Physiological changes of pregnancy and the Swansea criteria in diagnosing acute fatty liver of pregnancy.

Obstet Med 2018 Sep 16;11(3):126-131. Epub 2018 Apr 16.

Mater Health, University of Queensland, Brisbane, Australia.

The Swansea criteria are used to assess the likelihood of acute fatty liver of pregnancy. There are significant physiological changes in normal pregnancy in several of the pathology parameters used in the Swansea criteria. This may impact the sensitivity and specificity of the Swansea criteria. Read More

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http://dx.doi.org/10.1177/1753495X18759353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134352PMC
September 2018
3 Reads

Transversus Abdominis Plane Block With Ilioinguinal-Iliohypogastric Nerve a Viable Alternative to Provide Surgical Anesthesia for Cesarean Delivery: A Case Report.

A A Pract 2018 Aug 29. Epub 2018 Aug 29.

Anaesthesia, Lady Hardinge Medical College, New Delhi, India.

Acute fatty liver of pregnancy is one of the most common causes of fulminant hepatic failure. A 28-year-old G3P1L1A1 presented at 37 weeks with diagnosis of acute fatty liver of pregnancy with grade 3 hepatic encephalopathy. Laboratory findings were suggestive of coagulopathy, metabolic acidosis, and liver and renal dysfunction. Read More

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http://Insights.ovid.com/crossref?an=02054229-900000000-9979
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http://dx.doi.org/10.1213/XAA.0000000000000875DOI Listing
August 2018
8 Reads

Markedly higher sFlt-1/PlGF ratio in a woman with acute fatty liver of pregnancy compared with HELLP syndrome.

J Obstet Gynaecol Res 2019 Jan 23;45(1):96-103. Epub 2018 Aug 23.

Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.

Aim: To compare serum levels of angiogenesis-related factors between 14 women with HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and a woman with acute fatty liver of pregnancy (AFLP).

Methods: Serum samples were collected in 2004-2008 and 2013-2016. The levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured by an automated electrochemiluminescence immunoassay using Elecsys sFlt-1 and Elecsys PlGF. Read More

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http://dx.doi.org/10.1111/jog.13786DOI Listing
January 2019
14 Reads

[Abnormal liver tests during pregnancy - emergency department decision making].

Rev Med Suisse 2018 Aug;14(614):1382-1385

Service de médecine interne générale, Département de médecine interne, réhabilitation et gériatrie, HUG, 1211 Genève 14.

Abnormal liver biochemical and function tests is common problem among patients in emergency department and can result from many different pathologies. In pregnant women, causes are sometime life-threating for the mother and the fetus. The role of emergency physician is : 1) to differentiate between serious (HELPPS syndrome, pre-eclampsia and eclampsia, acute fatty liver of pregnancy) and minor (intrahepatic cholestasis, hyperemesis gravidarum) pregnancy related liver disease and 2) to recognize non-pregnancy related liver disease. Read More

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August 2018
4 Reads

HELLP Syndrome: Pathophysiology and Current Therapies.

Curr Pharm Biotechnol 2018 ;19(10):816-826

Mississippi Center for Advanced Medicine - Maternal-Fetal-Medicine, Madison, Mississippi, United States.

HELLP syndrome is a disorder associated with serious maternal morbidity and mortality. Distinguishing HELLP from other pregnancy-related disorders is often challenging and may result in delay of treatment. Differential diagnoses include acute fatty liver of pregnancy, thrombotic thrombocytopenic purpura, antiphospholipid syndrome, and hemolytic uremic syndrome, and are reviewed in this chapter. Read More

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http://dx.doi.org/10.2174/1389201019666180712115215DOI Listing
January 2018
5 Reads

Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know?

Ann Gastroenterol 2018 Jul-Aug;31(4):385-394. Epub 2018 Apr 27.

Surgical Department, Gastroenterology Division (Catarina Frias Gomes, Joana Torres), Hospital Beatriz Ângelo, Loures, Portugal.

Pregnancy is characterized by numerous physiological changes that may lead to a diversity of symptoms and frequently to gastrointestinal complaints, such as heartburn, nausea and vomiting, or constipation. Chronic gastrointestinal diseases require treatment maintenance during this period, raising the challenging question whether outcomes beneficial to the mother may be harmful for the fetus. In addition, certain diseases, such as acute fatty liver of pregnancy, only develop during pregnancy and may require urgent procedures, such as fetus delivery. Read More

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http://dx.doi.org/10.20524/aog.2018.0264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033757PMC
April 2018
22 Reads

Cryo-EM structure of human mitochondrial trifunctional protein.

Proc Natl Acad Sci U S A 2018 07 18;115(27):7039-7044. Epub 2018 Jun 18.

State Key Laboratory of Protein and Plant Gene Research, Peking University, 100871 Beijing, China;

The mitochondrial trifunctional protein (TFP) catalyzes three reactions in the fatty acid β-oxidation process. Mutations in the two TFP subunits cause mitochondrial trifunctional protein deficiency and acute fatty liver of pregnancy that can lead to death. Here we report a 4. Read More

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http://dx.doi.org/10.1073/pnas.1801252115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142257PMC
July 2018
4 Reads
9.810 Impact Factor

Liver Disease During Pregnancy: A Challenging Clinical Issue.

Med Sci Monit 2018 Jun 15;24:4080-4090. Epub 2018 Jun 15.

Department of Gastroenterology, University Hospital Center (UHC) Rijeka, School of Medicine, University of Rijeka, Rijeka, Croatia.

One of the least studied topics in the field of obstetrics is liver disease during pregnancy, which creates a challenge for both gynecologists and hepatologists. Approximately 3% of pregnant women are affected by some form of liver disease during pregnancy. Some of these conditions can be fatal for both the mother and child. Read More

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http://dx.doi.org/10.12659/MSM.907723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034557PMC
June 2018
4 Reads

Postpartum acute fatty liver of pregnancy: a case report.

J Med Case Rep 2018 Jun 1;12(1):67. Epub 2018 Jun 1.

Obstetrics & Gynecology Department, Faculty of Medicine, University of Jordan and Jordan University Hospital, P.O. Box 2194, Amman, 11941, Jordan.

Background: Acute fatty liver of pregnancy can be a very dramatic clinical event with significant risk of mortality to healthy women. The pathogenesis is still unknown. It usually occurs in the third trimester or in the immediate postpartum period. Read More

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https://jmedicalcasereports.biomedcentral.com/articles/10.11
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http://dx.doi.org/10.1186/s13256-018-1593-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984337PMC
June 2018
5 Reads

Acute Kidney Injury in Pregnancy: The Changing Landscape for the 21st Century.

Kidney Int Rep 2018 Mar 2;3(2):247-257. Epub 2018 Feb 2.

Division of Nephrology, Department of Medicine, Jacobi Medical Center at Albert Einstein College of Medicine, Bronx, New York, USA.

Pregnancy-related acute kidney injury (Pr-AKI) remains a large public health problem, with decreasing incidences in developing countries but seemingly increasing incidences in the United States and Canada. These epidemiologic changes are reflective of the advances in medical and obstetric care, as well as changes in underlying maternal risk factors. The risk factors associated with advanced maternal age, such as hypertension, diabetes, chronic kidney disease, and those associated with reproductive technologies such as multiple gestations, are increasing. Read More

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http://dx.doi.org/10.1016/j.ekir.2018.01.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932309PMC
March 2018
10 Reads

[Liver disease and maternal mortality].

Arkh Patol 2018 ;80(2):43-47

Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk, Russia.

Liver diseases associated (acute fatty liver of pregnancy) and unassociated (liver hemangioma) with pregnancy and complications due to liver failure are serious conditions and can lead to maternal death. The paper describes two maternal deaths related to liver pathology. Read More

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http://dx.doi.org/10.17116/patol201880243-47DOI Listing
January 2018
1 Read

Intrahepatic Cholangiocarcinoma Masquerading as Acute Fatty Liver of Pregnancy: A Case Report and Review of the Literature.

Case Reports Hepatol 2018 26;2018:6939747. Epub 2018 Feb 26.

Division of Gastroenterology, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

Cholangiocarcinoma (CCA) is an uncommon cancer and accounts only for 3% of all gastrointestinal malignancies. In this report, we present a case of an intrahepatic cholangiocarcinoma masquerading as acute fatty liver of pregnancy (AFLP). A 38-year-old female who is 36-week pregnant presented with a 1-week history of headache, nausea, vomiting, and right upper abdominal pain, along with hepatomegaly. Read More

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https://www.hindawi.com/journals/crihep/2018/6939747/
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http://dx.doi.org/10.1155/2018/6939747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846373PMC
February 2018
5 Reads

Acute Fatty Liver of Pregnancy: A Thorough Examination of a Harmful Obstetrical Syndrome and Its Counterparts.

Cureus 2018 Feb 6;10(2):e2164. Epub 2018 Feb 6.

Attending Physician In Maternal Fetal Medicine, Cedars-Sinai Medical Center, Voluntary Clinical Professor at the Keck School of Medicine Dept. of Ob-Gyn, University of Southern California.

Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache. Read More

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http://dx.doi.org/10.7759/cureus.2164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889153PMC
February 2018
19 Reads

The Hibernating Bear-A Good Analogy to Explain Why Acute Fatty Liver of Pregnancy Manifests in Late Pregnancy.

Am J Gastroenterol 2018 Feb;113(2):307-308

Department of Hepatology, Christian Medical College, Vellore, India.

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http://dx.doi.org/10.1038/ajg.2017.462DOI Listing
February 2018
4 Reads

Acute fatty liver of pregnancy simulating liver tumor.

Clin Case Rep 2018 01 28;6(1):230-231. Epub 2017 Nov 28.

Department of Hepatology and Gastroenterology University Hospital of Tours Tours France.

Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy that can lead to acute liver failure. Clinicians must have a high index of suspicion for AFLP because only early diagnosis and prompt delivery improve maternal and fetal prognosis. Read More

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http://dx.doi.org/10.1002/ccr3.1293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771878PMC
January 2018
4 Reads

Role of 3-Hydroxy Fatty Acid-Induced Hepatic Lipotoxicity in Acute Fatty Liver of Pregnancy.

Int J Mol Sci 2018 Jan 22;19(1). Epub 2018 Jan 22.

Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, USA.

Acute fatty liver of pregnancy (AFLP), a catastrophic illness for both the mother and the unborn offspring, develops in the last trimester of pregnancy with significant maternal and perinatal mortality. AFLP is also recognized as an obstetric and medical emergency. Maternal AFLP is highly associated with a fetal homozygous mutation (1528G>C) in the gene that encodes for mitochondrial long-chain hydroxy acyl-CoA dehydrogenase (LCHAD). Read More

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http://www.mdpi.com/1422-0067/19/1/322
Publisher Site
http://dx.doi.org/10.3390/ijms19010322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796265PMC
January 2018
6 Reads

[Clinical features and treatment of acute fatty liver of pregnancy complicated by acute liver failure].

Zhonghua Gan Zang Bing Za Zhi 2017 Dec;25(12):938-939

Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

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http://dx.doi.org/10.3760/cma.j.issn.1007-3418.2017.12.010DOI Listing
December 2017
2 Reads

Acute kidney injury in pregnancy with special reference to pregnancy-specific disorders: a hospital based study (2014-2016).

J Nephrol 2018 02 4;31(1):79-85. Epub 2018 Jan 4.

Department of Radiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.

Introduction: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. Read More

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http://dx.doi.org/10.1007/s40620-017-0466-yDOI Listing
February 2018
18 Reads

Outcomes and risk factors of patients with acute fatty liver of pregnancy: a multicentre retrospective study.

Singapore Med J 2018 08 3;59(8):425-430. Epub 2018 Jan 3.

Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.

Introduction: Acute fatty liver of pregnancy (AFLP) frequently causes liver failure in pregnant women. A better understanding of the clinical characteristics, management, outcomes and risk factors of AFLP is required, given its relatively high mortality rate. We aimed to describe the characteristics of AFLP, and further assess its outcomes and potential risk factors from the perspectives of the mother and fetus. Read More

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http://dx.doi.org/10.11622/smedj.2018001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109830PMC
August 2018
87 Reads

Presumed acute fatty liver of pregnancy following influenza A hepatitis.

Authors:
Adam Morton

Obstet Med 2017 Dec 11;10(4):186-188. Epub 2017 Apr 11.

Mater Health and University of Queensland, South Brisbane, Queensland, Australia.

Acute fatty liver of pregnancy is a rare mitochondrial hepatopathy characterised by microvesicular fatty infiltration, and is believed to be due to impaired fatty acid oxidation. Hepatitis following influenza virus infection is uncommon. Rarely influenza virus infection may be complicated by Reye's syndrome, another hepatic microvesicular fat disease. Read More

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http://journals.sagepub.com/doi/10.1177/1753495X17695173
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http://dx.doi.org/10.1177/1753495X17695173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714101PMC
December 2017
6 Reads

Clinical characteristics of acute fatty liver of pregnancy in a tertiary Indonesian hospital.

J Matern Fetal Neonatal Med 2017 Oct 16:1-191. Epub 2017 Oct 16.

a Department Obstetrics & Gynaecology , Universitas Airlangga , RSUD dr. Soetomo , Surabaya , Indonesia.

Acute fatty liver of pregnancy (AFLP) is a rare, often autosomal recessive disorder with a major risk for maternal and perinatal mortality and morbidity. In order to achieve a more favorable outcome, awareness of its clinical signs and symptoms and early recognition are of pivotal importance. Over a 5-year period 18 patients were diagnosed with AFLP (one twin, 19 babies). Read More

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http://dx.doi.org/10.1080/14767058.2017.1393067DOI Listing
October 2017
12 Reads

Acute Fatty Liver of Pregnancy-Differential Diagnosis.

Authors:
Adam Morton

Am J Gastroenterol 2017 Aug;112(8):1342

Mater Health and University of Queensland, Brisbane, Australia.

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http://www.nature.com/doifinder/10.1038/ajg.2017.133
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http://dx.doi.org/10.1038/ajg.2017.133DOI Listing
August 2017
4 Reads

Acute Kidney Injury in Pregnancy-specific Disorders.

Indian J Nephrol 2017 Jul-Aug;27(4):258-270

Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. Read More

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http://dx.doi.org/10.4103/0971-4065.202406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514821PMC
August 2017
12 Reads

Acute Kidney Injury in Pregnancy.

Semin Nephrol 2017 07;37(4):378-385

Division of Nephrology and Hypertension, and Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN. Electronic address:

Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas. Differentiating among these conditions may be difficult or impossible based on clinical criteria only. Read More

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http://dx.doi.org/10.1016/j.semnephrol.2017.05.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662118PMC
July 2017
14 Reads

[Retrospective analysis of anesthetic and perioperative management in patients of acute fatty liver of pregnancy].

Zhonghua Yi Xue Za Zhi 2017 Jun;97(24):1878-1882

Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.

To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2017.24.008DOI Listing
June 2017
11 Reads

[Acute fatty liver of pregnancy and mitochondrial fatty acid oxidation. Consequences for the offspring].

Arch Pediatr 2017 Aug 21;24(8):777-782. Epub 2017 Jun 21.

Service d'hépato-gastroentérologie, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex, France.

Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy that can lead to acute liver failure. The prognosis, initially often fatal for both mother and child, has been improved by prompt delivery. The diagnosis should be highly suspected if the mother presents epigastric pain, nausea and/or vomiting, or polyuria-polydipsia in the third trimester of pregnancy. Read More

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http://dx.doi.org/10.1016/j.arcped.2017.05.012DOI Listing
August 2017
5 Reads

Obstetric Disorders in the ICU.

Semin Respir Crit Care Med 2017 04 22;38(2):218-234. Epub 2017 May 22.

Intensive Care Unit, Sanatorio Anchorena, Autonomous City of Buenos Aires, Argentina.

Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment. Read More

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http://dx.doi.org/10.1055/s-0037-1600910DOI Listing
April 2017
12 Reads

Clinical and molecular investigation of 14 Japanese patients with complete TFP deficiency: a comparison with Caucasian cases.

J Hum Genet 2017 Sep 18;62(9):809-814. Epub 2017 May 18.

Department of Pediatrics, Shimane University Faculty of Medicine, Shimane, Japan.

Mitochondrial trifunctional protein (TFP) deficiency is an inherited metabolic disorder of mitochondrial fatty-acid oxidation. Isolated long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency is often reported in Caucasian countries due to a common mutation. However, the molecular and clinical basis of complete TFP deficiency has not been extensively reported. Read More

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http://dx.doi.org/10.1038/jhg.2017.52DOI Listing
September 2017
17 Reads

Acute Fatty Liver Disease of Pregnancy: Updates in Pathogenesis, Diagnosis, and Management.

Am J Gastroenterol 2017 Jun 14;112(6):838-846. Epub 2017 Mar 14.

Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

Acute fatty liver of pregnancy (AFLP) is an obstetric emergency characterized by maternal liver failure and may have complications for the mother and fetus, including death. This review examines recent literature on the epidemiology, pathogenesis, diagnosis, and treatment of acute fatty liver of pregnancy. Pathogenesis of this disease has been linked to defects in fatty acid metabolism during pregnancy, especially in the setting of fetal genetic defects in fatty acid oxidation. Read More

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http://dx.doi.org/10.1038/ajg.2017.54DOI Listing
June 2017
27 Reads

Hemostatic issues in pregnancy-induced liver disease.

Thromb Res 2017 Mar;151 Suppl 1:S78-S81

Liver Intensive Care Unit, Institute of Liver Studies, Kings College Hospital, Denmark Hill, London, United Kingdom.

Liver diseases may be accompanied by profound changes in the hemostatic system including thrombocytopenia, decreased plasma levels of pro- and anticoagulants, and alterations in plasma levels of fibrinolysis. The net effect of the hemostatic changes in chronic and acute liver diseases is a hemostatic system that is in relative balance due to the simultaneous decline in pro- and antihemostatic drivers. A unique category of liver diseases are those induced by pregnancy. Read More

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http://dx.doi.org/10.1016/S0049-3848(17)30073-7DOI Listing
March 2017
11 Reads

Disseminated intravascular coagulation in pregnancy - Clinical phenotypes and diagnostic scores.

Authors:
Offer Erez

Thromb Res 2017 Mar;151 Suppl 1:S56-S60

Maternity "D" Department, Division of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. Electronic address:

During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy. Acute obstetrical hemorrhage is one of the leading causes for DIC in pregnancy and is one of the most avoidable etiologies of maternal death. Read More

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http://dx.doi.org/10.1016/S0049-3848(17)30069-5DOI Listing
March 2017
5 Reads

Suspected atypical haemolytic uraemic syndrome in two post-partum patients with foetal-death in utero responding to eculizumab.

Nephrology (Carlton) 2017 Feb;22 Suppl 1:18-22

Department of Nephrology, Austin Hospital, Victoria, Australia.

Background: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy.

Case Reports: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively. Read More

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http://dx.doi.org/10.1111/nep.12935DOI Listing
February 2017
7 Reads

[Pregnancy-related acute kidney injury].

Wiad Lek 2016;69(5):721-724

Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych WUM, Warszawa, Polska.

Acute kidney injury (AKI) in obstetrics may be caused by the same disorders that are observed in the general population or may be specific for a pregnancy such as: preeclampsia, HELLP syndrome or acute fatty liver of pregnancy. The renal changes may be only temporary, and resolve within a few weeks postpartum, or may become irreversible leading to a progression of chronic kidney disease (CKD). In the article the most important pregnancy related syndromes associated with AKI have been shortly reviewed. Read More

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March 2017
6 Reads

Association of antenatal antithrombin activity with perinatal liver dysfunction: A prospective multicenter study.

J Gastroenterol Hepatol 2017 Jul;32(7):1378-1386

Department of Obstetrics, Hokkaido University Hospital, Sapporo, Japan.

Background And Aim: Liver dysfunction with decreased antithrombin (AT) activity and/or thrombocytopenia is life threatening in pregnant women. Whether AT is clinically useful for prediction of liver dysfunction remains unclear.

Methods: A total of 541 women were registered prospectively at gestational week 34. Read More

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http://doi.wiley.com/10.1111/jgh.13714
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http://dx.doi.org/10.1111/jgh.13714DOI Listing
July 2017
15 Reads

Liver dysfunction in women with pregnancy-induced antithrombin deficiency.

J Obstet Gynaecol Res 2017 Feb 19;43(2):257-264. Epub 2016 Dec 19.

Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Aim: The aim of this study was to determine whether women with pregnancy-induced antithrombin deficiency (PIATD) had higher risk of liver dysfunction in the absence of thrombocytopenia.

Methods: We carried out a retrospective observational study at five centers in all 129 women with incidentally found PIATD among 5249 maternities and 129 control women without PIATD matched for number of fetuses and gestational week at delivery. PIATD was diagnosed in women with antenatal antithrombin (AT) activities of ≤75% followed by a further decrease to ≤65% peripartum. Read More

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http://dx.doi.org/10.1111/jog.13210DOI Listing
February 2017
14 Reads

Noninvasive Swansea criteria are valuable alternatives for diagnosing acute fatty liver of pregnancy in a Chinese population.

J Matern Fetal Neonatal Med 2017 Dec 4;30(24):2951-2955. Epub 2017 Jan 4.

a Department of Obstetrics and Gynecology , Shandong Provincial Hospital affiliated to Shandong University , Jinan , China.

Background: This study aims to assess the diagnostic and prognostic value of Swansea criteria in diagnosing acute fatty liver of pregnancy (AFLP) in a Chinese population.

Methods: A retrospective study was conducted on 52 Chinese women diagnosed with AFLP. All selected cases were reassessed using the Swansea criteria with special focus on the noninvasive criteria, since performing a liver biopsy for this indication is rare in a Chinese population. Read More

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https://www.tandfonline.com/doi/full/10.1080/14767058.2016.1
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http://dx.doi.org/10.1080/14767058.2016.1269316DOI Listing
December 2017
16 Reads

Etiology, clinical profile, and outcome of liver disease in pregnancy with predictors of maternal mortality: A prospective study from Western India.

Indian J Gastroenterol 2016 Nov 31;35(6):450-458. Epub 2016 Oct 31.

Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400 022, India.

Background: The aim of this study is to study the etiology, clinical profile, and prognostic factors related to maternal and fetal health in pregnant patients with liver disease in Western India.

Methods: This study included 103 consecutive pregnant patients with liver dysfunction from August 2013 to July 2015, who underwent regular biochemical tests, viral markers, ultrasound of abdomen, etc. and were followed up for 6 weeks postpartum or until death. Read More

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http://dx.doi.org/10.1007/s12664-016-0704-6DOI Listing
November 2016
10 Reads
1 Citation

Postpartum Acute Liver Dysfunction: A Case of Acute Fatty Liver of Pregnancy Developing Massive Intrahepatic Calcification.

Gastroenterology Res 2015 Dec 31;8(6):313-315. Epub 2015 Dec 31.

Department of Internal Medicine, Safdarjang Hospital, Ansari Nagar, New Delhi 110029, India.

The function of the liver is particularly affected by the unique physiologic milieu of the pregnancy. Pregnancy-related liver diseases encompass a spectrum of different etiologies that are related to gestation or one of its complications. Hepatic calcification, a rare entity, is usually associated with infectious, vascular, or neoplastic lesions in the liver. Read More

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http://www.gastrores.org/index.php/Gastrores/article/view/69
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http://dx.doi.org/10.14740/gr693wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051032PMC
December 2015
17 Reads

Study of Abnormal Liver Function Test during Pregnancy in a Tertiary Care Hospital in Chhattisgarh.

J Obstet Gynaecol India 2016 Oct 29;66(Suppl 1):129-35. Epub 2015 Dec 29.

Department of Obstetrics and Gynaecology, Pt. J N M Medical College & BRAM Hospital Raipur (C.G.), Raipur, India.

Introduction: Abnormal liver function tests (LFTs) in pregnancy require proper interpretation in order to avoid pitfalls in the diagnosis. The underlying disorder can have a significant effect on the outcome of both mother and foetus. The present study was done with the objective to study the clinical profile, incidence and possible causes of derangements of liver function tests. Read More

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http://dx.doi.org/10.1007/s13224-015-0830-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016438PMC
October 2016
8 Reads

Acute Fatty Liver of Pregnancy: A Life-Threatening Condition Requiring a Life-Saving Approach.

Hepat Mon 2016 Jun 25;16(6):e35256. Epub 2016 May 25.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Tehran Hepatitis Center, Tehran, IR Iran.

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http://dx.doi.org/10.5812/hepatmon.35256DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010886PMC
June 2016
7 Reads
1.800 Impact Factor

Changing picture of acute kidney injury in pregnancy: Study of 259 cases over a period of 33 years.

Indian J Nephrol 2016 Jul-Aug;26(4):262-7

Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. Read More

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http://dx.doi.org/10.4103/0971-4065.161018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964686PMC
August 2016
5 Reads

Acute Fatty Liver of Pregnancy: Analysis on the Diagnosis and Treatment of 15 Cases.

J Reprod Med 2016 May-Jun;61(5-6):282-6

Objective: To describe our experience with the diagnosis and management of acute fatty liver of pregnancy (AFLP).

Study Design: The medical records of pregnant women with AFLP were reviewed for symptoms, laboratory findings, treatment, and maternal and fetal outcomes during a 10-year period between January 2003 and December 2013.

Results: During the study period 15 women had AFLP as their discharge diagnosis. Read More

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August 2016
35 Reads