Document Detail


Case report: anesthetic management of acute fatty liver of pregnancy in the postpartum period.
MedLine Citation:
PMID:  20572409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute fatty liver of pregnancy (AFLP) is a potentially fatal metabolic disorder that manifests during the third trimester. Early diagnosis, termination of pregnancy, and treatment of complications associated with AFLP significantly reduce maternal morbidity and mortality. While most cases of AFLP occur before delivery, some may occur after vaginal delivery. Anesthesia providers should have a high level of suspicion for AFLP in a patient with altered mental status and elevated liver function test results in the postpartum period. Anesthetic implications include early recognition of liver dysfunction and aggressive resuscitation and treatment of hypoglycemia, disseminated intravascular coagulopathy, and other associated complications and reduction or avoidance of medications with substantial hepatic metabolism. This is a case report describing the management of a woman with AFLP in whom acute liver failure rapidly developed after a vaginal delivery with epidural analgesia at a small overseas hospital.
Authors:
Dennis Spence
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  AANA journal     Volume:  78     ISSN:  0094-6354     ISO Abbreviation:  AANA J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431420     Medline TA:  AANA J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-8     Citation Subset:  N    
Affiliation:
Uniformed Services University of the Health Sciences, Nurse Anesthesia Program, Naval Medical Center San Diego, California, USA. dennis.spence@med.navy.mil
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Anesthesia, Epidural* / adverse effects,  nursing
Anesthesia, Obstetrical* / adverse effects,  nursing
Critical Care
Diagnosis, Differential
Disseminated Intravascular Coagulation / etiology
Early Diagnosis
Fatty Liver* / diagnosis,  etiology,  therapy
Female
Humans
Liver Failure, Acute / etiology
Nurse Anesthetists
Postnatal Care
Pregnancy
Puerperal Disorders* / diagnosis,  etiology,  therapy
Resuscitation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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