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Chen J, Huang ZB, Fan XG, Hu XW, Qi M, Liao CJ, Long LY, Huang Y. Potential predictors for prognosis and postpartum recovery time of acute fatty liver of pregnancy. BMC Pregnancy Childbirth 2020; 20:601. [PMID: 33028240 PMCID: PMC7542749 DOI: 10.1186/s12884-020-03287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/25/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Acute fatty liver of pregnancy (AFLP) is a potentially lethal condition of pregnant women with a high mortality rate. Potential predictors related to postpartum recovery time and prognostic factors of AFLP are still unclear. This study aimed to evaluate potential predictors for prognosis and postpartum recovery time of AFLP. METHODS We retrospectively analyzed the clinical data of 76 AFLP patients in our hospital from 2002 to 2017 and investigated potential predictors using univariate analysis and multivariate logistic regression analysis. RESULTS Hepatic encephalopathy (HE) was found to be associated with prognosis in AFLP patients (P = 0.005, OR = 26.844). The postpartum recovery time analysis showed that AFLP patients with a age < 25 had the shortest recovery time, but no significant difference (P = 0.134, OR = 5.952). The postpartum recovery time of patients with liver failure (LF) was significantly prolonged compared to those without LF (P = 0.036, OR = 10.052). Cryoprecipitate, and plasma infusion showed no significant effect on prognosis or recovery time. Artificial liver support therapy (ALST) had no effect on prognosis, but it might affect postpartum recovery time with no statistical significance (P = 0.128, OR = 5.470). CONCLUSION HE is a potential predictor for prognosis of AFLP. LF is a potential predictor for postpartum recovery time.
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Affiliation(s)
- Jun Chen
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Ze-Bing Huang
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Xue-Gong Fan
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Xing-Wang Hu
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Min Qi
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Cheng-Jin Liao
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Li-Yuan Long
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China
| | - Yan Huang
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Kaifu District, Xiangya Road 87, Changsha, 410008, China.
- Key Laboratory of Viral Hepatitis, Changsha, Hunan, China.
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Chen G, Huang K, Ji B, Chen C, Liu C, Wang X, Zhao X. Acute fatty liver of pregnancy in a Chinese Tertiary Care Center: a retrospective study. Arch Gynecol Obstet 2019; 300:897-901. [PMID: 31435779 DOI: 10.1007/s00404-019-05259-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 08/06/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To describe some prenatal clinical features and laboratory findings of AFLP and provide the clinicians with potential predictors in postpartum recovery time. METHODS Forty-four cases of AFLP previously treated in the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed. RESULTS The maternal and fetal mortalities after treatment were both 18.2%. The main symptoms of AFLP were nausea and vomiting (63.6%), jaundice (61.4%). Moreover, the most common maternal complication was acute renal dysfunction (79.5%), followed by DIC (47.7%) and MODS (38.6%). The level of platelets, total protein and total bilirubin were found to be correlated with postpartum recovery time (Pearson correlation coefficient 0.434, P = 0.008; 0.466, P = 0.005; 0.484, P = 0.003). CONCLUSIONS AFLP is a rare, but lethal complication in the third trimester. Termination of pregnancy should be applied once AFLP was highly suspected. Prenatal platelets, total protein and total bilirubin may be potential predictors of postpartum recovery.
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