A Case of Acute Fatty Liver of Pregnancy with Disseminated Intravascular Coagulation

Abstract

Acute fatty liver of pregnancy has been recognized as the definite clinical and histopathological entity with high maternal mortality. Having the opportunity to treat one case complicated by DIC with peritoneal dialysis, we discussed on direct cause of death and treatment in addition to a review of reference. Case: A-25-year-old multiparous woman had acute fatty liver of pregnancy on admisson. Soon after delivery due to premature separation of placenta, icterus, hemorrhagic tendency, and acute renal failure with delirium developed. It became apparent that she was suffering from DIC by the various clinical manifestations and laboratory findings. Because of oliguria and azotemia, peritoneal dialysis was carried out for nine days. After dialysis, her general condition was improved rapidly and coagulation abnormalities returned to normal values. Biopsy under direct view of laparoscopy was performed on the 30th hospital days and it revealed diffuse fine droplet of fatty infiltration of hepatocytes with no necrosis and inflammatory changes. Acorrding to this report, we emphasize the need for recognition and therapy for the extrahepatic manifestations. The possibility that themultisystem involvement of this disease was related to the presence of DIC was suggestive. © 1976, The Japan Society of Hepatology. All rights reserved.