Clinical Analysis Of 30 Cases Of Acute Fatty Liver Of Pregnancy

Background:Acute fatty liver of pregnancy (AFLP) is a characteristic disease in third-trimester, the overall incidence is 1/10000-1/15000, the mortality-rate reach up to 85%. Therefore familiaring the clinical characteristics and early diagnosis of AFLP, and prompt comprehensive treatment appear particularly important. At present, the domestic and foreign to AFLP reports and related research in an increasing number. Along with the development of technology of obstetrics, the early diagnosis and treatment AFLP work have made great progress in clinical, which make AFLP maternal and fetal deaths dropped significantly, but AFLP onset abruptly and has much complications, therefore the early diagnosis and treatment of AFLP are still the key points and difficulties in the clinical work.Objective:Discuss the gestational acute fatty liver characteristics of clinical cases and relatively analyzed. To improve the early stages diagnosis of AFLP and treatment ability, reduce maternal mortality and perinatal mortality rate. In order to further strengthen the perinatal management provide clinical evidence.Methods:This article selects 30 clinical cases which are all definitely diagnosised for gestational acute fatty liver (or AFLP) in QiLu hospital of shandong university from Dec.2005 to Dec.2010. The case features, including maternal age, clinical symptoms, liver and kidney function examination, the way of terminal pregnancy, treatment, the sex,weight and Apgar score of fetus etc, are analysed by retrospective study.Results:The maternal age is between 22 to 37-year-old, average age is (28.50±3.54) years old,80% of them is primipara;The male foetus are 19 cases, accounting for 63.33%; 6 cases are twins;21 patients appear obvious enteron symptom, accounting for 70%; 5 patients appear lower limb edema, accounting for 16.67%; 4 cases appear obvious jaundice, accounting for 6.67%; All of the patients present with liver or (and) renal abnormally; 3 cases appear coagulant fuctiong obstatcle;6 cases are also diagnosed as preeclampsia, accounting for 20%;3 cases which appear DIC account for 10%;21 cases appear amniotic fluid abnormally, accounting for 70%;There are 27 patients terminating pregnancy by cesarean section, and the other 3 patients do that by perineal operation;The average weight of perinatal infant is (2232±358)g, and 22 cases are 1 minute Apgar score≤7; Maternal death is one, with mortality 3%; Perinatal infant death is 4 cases (2 cases died for stillbirth), the mortality is 11.11%.Conclusion:The characteristics of Gestational acute fatty liver (AFLP) are sudden onset, fast progress and diversiform clinical manifestation. For this reason, the early diagnosis, timely termination of pregnancy and comprehensive coordination treatments of relevant clinical departments remain top priority in prevention and treatment department, and can effectively reduce the maternal and infant mortality.