Document Detail


Acute fatty liver of pregnancy; three cases and discussion of analgesia and anaesthesia.
MedLine Citation:
PMID:  17275281     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T L Gregory; S Hughes; M A Coleman; A De Silva
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-02-01
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  16     ISSN:  0959-289X     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-07-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  175-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Southampton General Hospital, Southampton, UK. tamsingregory@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / 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:
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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