Release date: 2008-05-27
Clinical diagnosis and treatment of acute fatty liver in pregnancy
The purpose of this study was to investigate the clinical diagnosis and treatment of acute fatty liver in pregnancy. Methods The clinical data of 36 patients with acute fatty liver disease who were admitted to the Shanghai Public Health Clinical Center from January 1988 to July 2007 were retrospectively analyzed. Results (1) Clinical manifestations: 36 cases of acute fatty liver disease in pregnancy occurred in the third trimester of pregnancy, with obvious clinical symptoms (mainly nausea and vomiting) and laboratory examination features (36 patients all had white blood cell count, liver enzymes and Serum total bilirubin levels were elevated, all prolonged prothrombin time and decreased serum albumin levels. The positive rate of liver B-ultrasound was 57% (17/30), the positive rate of liver CT was 73% (16/22), and the positive rate of liver CT was higher than that of B-ultrasound (P<0.05). ). (2) Mode of delivery: 12 cases of vaginal delivery, of which the incidence of postpartum hemorrhage was 42% (5/12), the maternal mortality rate was 50% (6/12), and the perinatal mortality rate was 50% (6/12). The incidence of neonatal asphyxia was 58% (7/12); 24 cases of cesarean delivery, including 42% (10/24) of postpartum hemorrhage and 8% (2/24) of maternal mortality. The infant mortality rate was 13% (3/24) and the neonatal asphyxia rate was 38% (9/24). (3) cesarean section termination of pregnancy plus internal medicine comprehensive support treatment can significantly reduce the incidence of postpartum hemorrhage, maternal mortality, perinatal mortality, neonatal asphyxia. The difference in maternal mortality and perinatal mortality between cesarean delivery and vaginal delivery was statistically significant (P<0.05), the incidence of postpartum hemorrhage in cesarean delivery and the incidence of neonatal asphyxia and vaginal delivery. The difference was not statistically significant (P>0.05). (4) All deaths were from onset to patients who received regular treatment for more than 7 days. From this, it is concluded that combined with clinical symptoms, experimental sputum examination features, liver B-ultrasound, CT examination, etc., strive to make a clear diagnosis within 1 week of onset; immediate cesarean section termination of pregnancy, active internal medicine comprehensive support therapy is to improve maternal and child prognosis key. - National Food and Drug Administration website
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