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Jan 2020, Vol 8, Issue 1
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Case Report
Acute Fatty Liver of Pregnancy: A Case Report
Mitra Eftekhariyazdi1, Behnaz Souizi1, Manijeh Yousefi Moghaddam2, Forough Mortazavi3
1Department of Obstetrics and Gynecology, School of Medicine, Sabzvar University of Medical Sciences, Sabzevar, Iran
2Department of Anesthesiology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
3Department of Midwifery, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran

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Keywords : Acute fatty liver,Gestational, therapy,Liver dysfunction,Postpartum,Pregnancy complications
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Objectives: Acute fatty liver of pregnancy (AFLP) is a rare condition with an incidence rate of 1 to 20000 and mostly occurs in the third trimester of pregnancy. There is no specific treatment for AFLP and a conservative treatment is usually applied.

Case Presentation: In this case report, we present a 28-year-old woman G3 P1 Ab1 L1 at 29 weeks of pregnancy who was referred to our emergency ward from a primary setting with an epigastric pain, a mild hypertension, and suspicion of HELLP syndrome. Lab exams ruled out the viral infections including HBV, HCV, and HIV. In addition, urine protein was 40 mg/600 cc. Because of elevated liver enzymes, proteinuria in the normal range for pregnancy, ruling out viral infections that involve the liver, and not having pruritus, AFLP was diagnosed and cesarean was performed under spinal analgesia. A 29-week girl with a weight of 1115 gm was born and the patient discharges with a good condition.At five days postpartum, she came with abdominal pain, fever, and incisional redness and discharge. The ultrasound scan showed a hematoma in the depth of the subdermis point of the cesarean incision. Antibiotics And one unit of fresh frozen plasma were infused. On 14-days postpartum, the patient was discharged with a good condition.The purpose of this study was to focus the attention of physicians to the point that AFLP may improve after childbirth but it may predispose the patient to coagulation disorders and hematoma.

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