Acute Fatty Liver of Pregnancy: Report of Three Cases

妊娠急性脂肪肝：三病例報告

姚志達(Chih-Ta Yao) ； 蘇維文(Wei-Wen Su) ； 孫茂勝(Maw-Soan Soon) ； 吳順生(Shun-Sheng Wu) ； 陳洋源(Yang-Yuan Chen) ； 顏旭亨(Hsu-Heng Yen) ； 楊佳偉(Chia-Wei Yang) ； 葉坤土(Kun-Tu Yeh)

《臺灣消化醫學雜誌》 25卷2期 (2008/06) Pp. 183-189

https://doi.org/10.6557/GJT.200806_25(2).0004

摘要

妊娠急性脂肪肝爲一罕見且易致命的疾病，通常發生於妊娠末期。起因在於肝臟微粒脂肪浸潤，進而影響肝功能、凝血功能；甚至造成肝及其他器官衰竭。我們報告三個典型的妊娠急性脂肪肝的案例，包括病人年齡、妊娠年齡、症狀、實驗室檢查結果、臨床過程及治療、病人及胎兒的結果。當妊娠末期時，發生嘔吐、腹痛、黃疸及上腹痛，應高度意識到妊娠急性脂肪肝的可能。早期診斷，早期分娩及積極的支持性治療可以改善存活率。此外我們建議病人及其親代、配偶作基因篩檢。

關鍵字

妊娠急性脂肪肝 ； 黃疸 ； 瀰漫性血管內凝血疾病

並列摘要

Acute fatty liver of pregnancy (AFLP) is a rare, potentially fatal disease that occurs late during the third trimester. It is associated with microvesicular fatty infiltration of the liver, hepatic failure, bleeding tendency and encephalopathy. Herein, we report three cases with acute fatty liver of pregnancy including initial presentations, laboratory findings, clinical course and maternal and perinatal outcomes. AFLP should be highly suspected in a pregnant woman that presents with nausea, vomiting, jaundice and epigastric pain during the third trimester. Early diagnosis, prompt delivery and aggressively supportive treatment usually result in a favorable outcome. Genetic screening is recommended in these patients, children and husband.

並列關鍵字

acute fatty liver of pregnancy AFLP ； jaundice ； disseminated intravascular coagulation DIC