妊娠期急性脂肪肝的诊断与治疗

Diagnosis and treatment of acute fatty liver of pregnancy

妊娠期急性脂肪肝(AFLP)是妊娠晚期一种特发性的严重并发症,孕产妇及围产儿死亡率高。该病缺乏特异性临床表现,需与妊娠期肝内胆汁淤积症等相鉴别,早期易误诊。肝活检是诊断AFLP的金标准,但根据病史、临床表现结合实验室及影像学检查,不必肝脏穿刺也可以做出临床诊断。迅速终止妊娠并给予支持治疗是主要治疗措施,对改善AFLP患者母胎结局至关重要。

Acute fatty liver of pregnancy （AFLP） is a serious maternal illness that occurs in the third trimester of pregnancy. Since AFLP can lead to significant maternal and fetal morbidity and mortality. The most definitive test is liver biopsy. Early diagnosis of AFLP sometimes can be difficult because it shares features with other common conditions such as cholestasis of pregnancy. However, a careful history and , in conjunction with compatible laboratory and imaging results, are often sufficient to make the diagnosis, and liver biopsy is rarely indicated. Supportive care and expeditious delivery are essential to optimal maternal-fetal outcomes and remain as the mainstay treatment for AFLP.