title: [Causes and management of severe acute liver damage during pregnancy].
abstract: 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.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Sepulveda-Martinez
authors.forename: Carlos
authors.initials: C
authors.lastname: Romero
authors.forename: Guido
authors.initials: G
authors.lastname: Juarez
authors.forename: Jorge
authors.initials: J
authors.lastname: Hasbun
authors.forename: Mauro
authors.initials: M
authors.lastname: Parra-Cordero
mesh_terms: D005234:Fatty Liver / Q000209:etiology / Q000628:therapy; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000209:etiology / Q000628:therapy; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011263:Pregnancy Trimester, Third