Document Detail

Disseminated intravascular coagulation and antithrombin III depression in acute fatty liver of pregnancy.
MedLine Citation:
PMID:  8572009     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Acute fatty liver of pregnancy has been associated with a syndrome of marked depression of antithrombin III and disseminated intravascular coagulation. We sought to identify the clinical importance of this accelerated coagulation. STUDY DESIGN: The medical records of patients with acute fatty liver of pregnancy identified during the period of 1982 to 1994 were retrospectively reviewed. RESULTS: Twenty-eight patients with acute fatty liver of pregnancy were identified for an incidence of 1:6692 births. Laboratory evidence of persistent disseminated intravascular coagulation was found in all patients tested. Six patients had clinical bleeding, all associated with genital tract injury. Twenty-three of twenty-three patients tested had markedly decreased antithrombin III levels (average 11%, normal range 80% to 100%). Seven patients received antithrombin III transfusions, which was associated with a significant transient rise in the plasma level. Compared with patients not transfused, however, there was a similar clinical outcome. CONCLUSION: Profoundly depressed antithrombin III levels and laboratory evidence of disseminated intravascular coagulation were present in all cases of acute fatty liver of pregnancy but rarely influenced clinical outcome unless there was concomitant genital tract injury. Antithrombin III transfusions increased plasma levels, but no definite clinical benefit was established in this series because of the small number of cases.
M A Castro; T M Goodwin; K J Shaw; J G Ouzounian; W G McGehee
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  174     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-03-04     Completed Date:  1996-03-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  211-6     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of Southern California Medical Center, Los Angeles, USA.
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MeSH Terms
Acute Disease
Antithrombin III Deficiency*
Disseminated Intravascular Coagulation / complications*
Fatty Liver / complications*
Gestational Age
Pregnancy Complications / blood*

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