| Acute fatty liver of pregnancy; three cases and discussion of analgesia and anaesthesia. | |
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MedLine Citation:
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PMID: 17275281 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute fatty liver of pregnancy is a rare, potentially fatal, complication of late pregnancy. The incidence is estimated at 1:7000-1:15000 pregnancies. Presentation is classically with malaise, nausea and vomiting, abdominal pain and rarely encephalopathy. Prolongation of laboratory clotting tests is an early feature. Ultrasound examination of the liver is performed to exclude biliary stasis. Rapid clinical deterioration may occur and urgent delivery should be organised. Anaesthetists form part of a multidisciplinary approach before, during and after delivery but there are few reports of anaesthetic involvement. One dilemma facing an anaesthetist called to assist in these cases is the potentially negative effect of general anaesthesia on hepatic encephalopathy versus the risks associated with regional anaesthesia in the presence of coagulopathy. Postoperative analgesia may also be complicated by impaired renal and hepatic function. We present three cases that occurred in our unit in a 6-month period illustrating the spectrum of disease severity and the successful use of different anaesthetic techniques to facilitate management including delivery. |
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Authors:
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T L Gregory; S Hughes; M A Coleman; A De Silva |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2007-02-01 |
Journal Detail:
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Title: International journal of obstetric anesthesia Volume: 16 ISSN: 0959-289X ISO Abbreviation: Int J Obstet Anesth Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-19 Completed Date: 2007-07-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9200430 Medline TA: Int J Obstet Anesth Country: Netherlands |
Other Details:
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Languages: eng Pagination: 175-9 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia, Southampton General Hospital, Southampton, UK. tamsingregory@doctors.org.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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etiology Acetylcysteine / administration & dosage Acute Disease Adult Analgesia, Obstetrical / methods* Anesthesia, Obstetrical / methods* Anti-Bacterial Agents / administration & dosage Blood Pressure Fatty Liver / complications*, diagnosis, drug therapy Female Fetal Death / etiology Free Radical Scavengers / administration & dosage Gastrointestinal Agents / administration & dosage Humans Lactulose / administration & dosage Nausea / etiology Pregnancy Pregnancy Complications* / diagnosis, drug therapy Rare Diseases Severity of Illness Index Tachycardia / etiology Vomiting / etiology |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Free Radical Scavengers; 0/Gastrointestinal Agents; 4618-18-2/Lactulose; 616-91-1/Acetylcysteine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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