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Revista médica de Chile

versão impressa ISSN 0034-9887

Resumo

SEPULVEDA-MARTINEZ, Alvaro et al. Causes and management of severe acute liver damage during pregnancy. Rev. méd. Chile [online]. 2015, vol.143, n.5, pp.627-636. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872015000500011.

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.

Palavras-chave : Acetaminophen; Fatty liver; HELLP; Liver failure; Pregnancy complications; Syndrome.

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