Actualización en el diagnóstico y manejo del daño hepático agudo grave en el embarazo

Abstract

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 di - sease . 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 . (Rev Med Chile 2015 ; 143 : 627 - 636)