title: [Acute fatty liver of pregnancy. About 22 cases].
abstract: OBJECTIVE
  To report the clinical experience, biochemical findings, complications and maternal outcome in patients with acute fatty liver of pregnancy (AFLP).
  
  
  METHODS
  Retrospective study over a period of 11 years (1993-2003). The diagnosis of AFLP was confirmed by liver biopsy in 15 women. However, in 7 women a medical committee that took into account clinical symptoms, and laboratory findings assessed the diagnosis.
  
  
  RESULTS
  Were included in this study, 22 women with a mean age of 30+/-5.4 years. Only 22.7% of cases were primigravid. The mean gestational age was 36+/-2.76 weeks (range 31-41 weeks). The fetus was a male infant in 75% of cases. Ten women were admitted in the hospital without jaundice. However 15 women had developed an icterus since their hospital admission or during ICU stay. The mean SAPS II on the ICU admission was of 24.86+/-11.2 points. Biological disturbances observed were mainly: liver cytolysis in 91% of cases, a trend to hypoglycaemia in 86%, a hypoprotidemia in 66.7% and CIVD in 32%. During their ICU stay, 19 women (86.4%) developed one or several organ failures associated to the hepatic failure and 18 women required blood transfusion. After an average stay of 7.5 days, evolution was marked by the death of seven patients (31.8%). Factors correlated with a poor prognosis were: the delay of medical consultation, the development of jaundice, the development of encephalopathy, respiratory or a circulatory failure.
  
  
  CONCLUSIONS
  AFLP is a rare but life-threatening complication. Furthermore AFLP shares features with other more common and less perilous illnesses. An early diagnosis and appropriate therapy of this pathology should improve the poor prognosis in our country.
authors.affiliation: Service de réanimation médicale, CHU Habib-Bourguiba, route El Ain, 3029 Sfax, Tunisie. bahloulmab@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Bahloul
authors.forename: H
authors.initials: H
authors.lastname: Dammak
authors.forename: N
authors.initials: N
authors.lastname: Khlaf-Bouaziz
authors.forename: K
authors.initials: K
authors.lastname: Trabelsi
authors.forename: A
authors.initials: A
authors.lastname: Khabir
authors.forename: C
authors.initials: C
authors.lastname: Ben Hamida
authors.forename: H
authors.initials: H
authors.lastname: Kallel
authors.forename: H
authors.initials: H
authors.lastname: Ksibi
authors.forename: H
authors.initials: H
authors.lastname: Chelly
authors.forename: A
authors.initials: A
authors.lastname: Chaari
authors.forename: N
authors.initials: N
authors.lastname: Rekik
authors.forename: M
authors.initials: M
authors.lastname: Bouaziz
mesh_terms: D000208:Acute Disease; D000328:Adult; D001803:Blood Transfusion; D003422:Critical Care; D005234:Fatty Liver / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D017093:Liver Failure / Q000150:complications; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies