Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 1927-1931
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1927
Acute fatty liver of pregnancy: Over six months follow-up study of twenty-five patients
Hao-Feng Xiong, Jing-Yuan Liu, Li-Min Guo, Xing-Wang Li
Hao-Feng Xiong, Jing-Yuan Liu, Li-Min Guo, Intensive Care Unit, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Xing-Wang Li, The Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Author contributions: Xiong HF and Liu JY contributed equally to this work; Xiong HF, Liu JY, Guo LM and Li XW designed research; Xiong HF and Liu JY performed research, analyzed data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xing-Wang Li, Professor, The Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Chaoyang District, Beijing 100015, China. ditanlxw@163.com
Telephone: +86-10-84322678 Fax: +86-10-84322678
Received: May 28, 2014
Peer-review started: May 28, 2014
First decision: June 27, 2014
Revised: July 29, 2014
Accepted: September 5, 2014
Article in press: September 5, 2014
Published online: February 14, 2015
Abstract

AIM: To evaluate the prognosis of patients with acute fatty liver of pregnancy (AFLP) 6 mo or longer after discharge.

METHODS: The records of pregnant patients diagnosed with AFLP at Beijing Ditan Hospital over a 16-year period were reviewed in November 2012. Patients were monitored using abdominal ultrasound, liver and kidney functions, and routine blood examination.

RESULTS: A total of 42 patients were diagnosed with AFLP during the study period, and 25 were followed. The mean follow-up duration was 54.5 mo (range: 6.5-181 mo). All patients were in good physical condition, but one patient had gestational diabetes. The renal and liver functions normalized in all patients after recovery, including in those with pre-existing liver or kidney failure. The ultrasound findings were normal in 12 patients, an increasingly coarsened echo-pattern and increased echogenicity of the liver in 10 patients, and mild to moderate fatty liver infiltration in 3 patients. Cirrhosis or liver nodules were not observed in any patient.

CONCLUSION: Acute liver failure and acute renal failure in AFLP patients is reversible. Patients do not require any specific long-term follow-up after recovery from AFLP if their liver function tests have normalized and they remain well.

Keywords: Acute fatty liver of pregnancy, Acute liver failure, Acute renal failure, Follow-up study

Core tip: Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening complication of pregnancy. Acute liver failure (ALF) and acute renal failure are the most important and threatening complication of AFLP. ALF due to viral hepatitis is known to potentially cause severe liver fibrosis and cirrhosis, but it is unknown whether the same outcome is possible for AFLP patients. The potential for continued progression or chronic sequelae is also unknown. Hence, the aim of this study was to evaluate the prognosis of patients with AFLP 6 mo or longer after discharge.