Actualización en el diagnóstico y manejo del daño hepático agudo grave en el embarazo
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Alvaro Sepulveda-Martinez [1] ; Carlos Romero [1] ; Guido Juarez [1] ; Jorge Hasbun [1] ; Mauro Parra-Cordero [1]
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[1] Universidad de Chile
Universidad de Chile
Santiago, Chile
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- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 143, Nº. 5, 2015, págs. 627-636
- Idioma: español
- Títulos paralelos:
- Causes and management of severe acute liver damage during pregnancy
- Enlaces
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Resumen
Abnormalities in liver function tests appear in 3% of pregnancies. Severe acute liver damage can be an exclusive condition of pregnancy (dependent or independent of pre-eclampsia) or a concomitant disease. HELLP syndrome and acute fatty liver of pregnancy are the most severe liver diseases associated with pregnancy. Both appear during the third trimester and have a similar clinical presentation. Acute fatty liver may be associated with hypoglycemia and HELLP syndrome is closely linked with pre-eclampsia. Among concomitant conditions, fulminant acute hepatitis caused by medications or virus is the most severe disease. Its clinical presentation may be hyper-acute with neurological involvement and severe coagulation disorders. It has a high mortality and patients should be transplanted. Fulminant hepatic failure caused by acetaminophen overdose can be managed with n-acetyl cysteine. Because of the high fetal mortality rate, the gestational age at diagnosis is crucial.
