गर्भावस्था में तीव्र वसायुक्त यकृत का उपचार क्या है?

References

DOI: 10.1016/j.jhep.2023.03.006

• Delivery should be expedited once coagulopathy and remediable metabolic derangements have been treated, and decisions about mode of delivery should be made jointly by obstetricians, hepatologists and the multidisciplinary team.
• Current recommended practice is to ensure coagulopathy, hypoglycaemia and metabolic acidosis are stabilised/corrected and then to expedite delivery of the fetus in women diagnosed with AFLP antenatally.
• In AFLP, small observational studies found that caesarean section is associated with improved maternal and perinatal outcomes compared to vaginal delivery.
• Nonetheless, generally rapid delivery after stabilisation of hypoglycaemia, acid-base balance and coagulopathy is recommended.
• However, when fetal demise has occurred, expedited vaginal induction could be considered (instead of caesarean section).
• Hepatocellular necrosis was demonstrated to peak at the time of delivery and showed prompt recovery with reduction of liver transaminase measurements to <100 IU/L by the second or third day postpartum.
• In a similar fashion, recovery of renal function was prompt after delivery.