Korean J Anesthesiol.  2002 Aug;43(2):249-254. 10.4097/kjae.2002.43.2.249.

Anesthetic Management for an Emergency Cesarean Section in a Patient Diagnosed with Acute Fatty Liver of Pregnancy after Delivery

• Im JA
• Chung RK
• Kim DY
• Lee GY
• Kim CH

• KMID: 2236773
• DOI: http://doi.org/10.4097/kjae.2002.43.2.249

Abstract

Acute fatty liver of pregnancy (AFLP) is a late gestational complication with clinical similarities to fulminant hepatic failure. The following case illustrates our experience with anesthesia for a cesarean section in a patient with AFLP, diagnosed after delivery. A 34-year-old woman, at 34 weeks gestation, presented in acute labor and uncontrolled gestational diabetes mellitus. She complained of a mild fever, jaundice, nausea and vomiting. Laboratory tests demonstrated an increased level of activated partial thromboplastin time, aspartate aminotransferase, and alanin aminotransferase. A cesarean section was performed under general anesthesia with O2-N2O-fentanyl-midazolam-vecuronium. After delivery, she was diagnosed as AFLP. The diagnosis was made by clinical, laboratory and an ultrasound of liver findings. After conservative treatment, she recovered and was discharged on postoperative day 16.

Keyword

Anesthesia; cesarean section; fatty liver; complication of pregnancy

MeSH Terms

Adult
Anesthesia
Anesthesia, General
Aspartate Aminotransferases
Cesarean Section*
Diabetes, Gestational
Diagnosis
Emergencies*
Fatty Liver*
Female
Fever
Humans
Jaundice
Liver
Liver Failure, Acute
Nausea
Partial Thromboplastin Time
Pregnancy
Pregnancy*
Ultrasonography
Vomiting
Aspartate Aminotransferases