[Screening time and schedule for outpatients with acute fatty liver of pregnancy].
OBJECTIVE
To identify the screening time and prepare a screening schedule for outpatients with acute fatty liver of pregnancy (AFLP).


METHODS
AFLP patients who admitted to Xiangya Hospital and the Second Xiangya Hospital, Central South University, Hunan, China between November, 2006 and December, 2013, were retrospectively studied. The diagnosis of 78 AFLP patients met the domestic clinical and laboratory criteria and the Swansea criteria. Clinical and laboratory data obtained on admission were used for analysis. Contrastive analysis was conducted within our data and other large medical centers or general hospitals.


RESULTS
The difference between domestic clinical and laboratory criteria and Swansea criteria in diagnosing AFLP patients in the 2 hospitals mentioned above was significant (P<0.05). The maternal mortality was 14.10% (11/78) and perinatal mortality was 17.95 % (14/78). The mean gestational age at delivery was 35.6 weeks. Based on the clinical and laboratory data, more than 85% of AFLP patients showed abnormal levels of transaminase, bilirubin, and white blood cells, as well as coagulation dysfunction. Gastrointestinal symptoms, such as abdominal pain and vomiting, jaundice, renal impairment and ascites or bright liver on ultrasound scan, were showed in 50%-85% of AFLP patients. Less than 50% of patients suffered from low blood sugar, high blood ammonia or hepatic encephalopathy.


CONCLUSIONS
The 34th gestation week might be important time for screening AFLP outpatients. Gastrointestinal symptoms, blood routine, liver function, and coagulant function tests are recommended as the first grade screening indicators. Renal function, blood sugar test, and abdominal ultrasound could be the second grade screening indicators for AFLP outpatients.
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Texuan
T
Zhu
Department of Clinical Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, China.
Qi
Q
Li
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Weishe
W
Zhang
Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Jian
J
Huang
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Qiaozhen
Q
Peng
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Yuelan
Y
Liu
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Weinan
W
Wang
Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Xinhua
X
Wu
Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Lijuan
L
Zhang
D002681:China; D005234:Fatty Liver / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010045:Outpatients; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D013997:Time Factors