Acute fatty liver of pregnancy About 20 cases

Abstract

Our retrospective study concerned acute hepatic steatosis in pregnancy: diagnostic problems, severity and therapeutic perspectives in the Moroccan context. It concerns a series of 20 cases of SHAG collected in the department of gynecology-obstetrics and maternal resuscitation of the CHU MOHAMED VI in Marrakech over a 5-year period from January 2017 to December 2021. We included in this sample women admitted during pregnancy or post partum for management of SHAG. In our series, the frequency of SHAG was 1 case per 4340 deliveries. The age of the patients ranged from 18 to 45 years, with an average of 28 years and an average gestational age of 32 days and 3 weeks. Thus the majority of patients were multiparous and multigestational with a frequency of 55%. Clinically: polyuria-polydipsia syndrome was present in 20% of patients, nausea-vomiting in 70% and epigastralgia in 60%. Biologically: Hypoglycaemia present in 60%, hyperleukocytosis in 85%, creatinine level above 12mg/l in 70%, hyperuricaemia in 75%, hepatic cytolysis in 90%, hyper bilirubinaemia in 95% with conjugated predominance, prolonged PT in 50% and hyperammonia in 10%. Concerning complications, acute fulminant liver failure was observed in 30% of our patients, it is the most serious and fatal complication. The therapeutic management of SHAG requires, in addition to uterine evacuation associated with adequate medical and surgical resuscitation.