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[Clinical diagnosis and treatment of acute fatty liver of pregnancy].

OBJECTIVE
To study the clinical diagnosis and treatment of acute fatty liver of pregnancy (AFLP).


METHOD
The clinical data of 36 cases of AFLP were reviewed retrospectively, who were treated during Jan 1988- July 2007 in the Department of Obstetrics and Gynecology, Public Health Clinical Center Affiliated to Fu Dan University, Shanghai.


RESULTS
All 36 cases were hospitalized in late pregnancy with various clinical symptoms and physical signs. Lab examinations were also performed. In the case of natural delivery, the rate of postpartum hemorrhage, and maternal mortality were 42%, and 50%, and the perinatal mortality and asphyxia in newborns were 50% and 58% respectively. In the case of cesarean section, the rate was 42%, 8%, and 13%, 38% respectively. The comprehensive therapies of termination of pregnancy by cesarean section plus medical supportive treatment can reduce the rate of postpartum hemorrhage, maternal mortality, perinatal mortality, and asphyxia in newborns significantly. Compared with the natural delivery, cesarean section had the higher rate of postpartum hemorrhage and the rate of asphyxia in newborns (P > 0.05), higher rate of maternal mortality and perinatal mortality (P < 0.05). All the death cases occurred in patients who only began to receive treatment 7 days after presentation of the symptoms. Compared with B ultrasonography, of which diagnosis rate of AFLP was 57%, CT had a higher diagnosis rate of 73% (P < 0.05).


CONCLUSION
Early diagnosis, termination of pregnancy by cesarean section as soon as possible and a comprehensive therapy are the key to improve the mother and newborn's prognosis.