Patient's question:
My wife is already seven and a half months pregnant and suddenly developed acute fatty liver during pregnancy. The situation is very urgent. The doctor recommended immediate termination of pregnancy to possibly save her life. The pregnancy has now been terminated, but she is still not improving. I am worried that delaying any further will be harmful to her health.Doctor's answer:
Hello, the treatment methods for acute fatty liver during pregnancy include:1. General treatment: Bed rest, a diet low in fat and protein but high in carbohydrates, to ensure sufficient calories. Intravenous glucose is administered to correct hypoglycemia. Maintain fluid and electrolyte balance and correct acidosis.
2. Blood exchange or plasma exchange: In foreign countries, blood exchange uses three times the blood volume. Combined with hemodialysis, this treatment was successful in one case of AFLP (Acute Fatty Liver of Pregnancy) with multiple organ failure. Plasma exchange can clear irritant factors from the blood, replenish deficient clotting factors, reduce platelet aggregation, and promote vascular endothelial repair. This method is widely used abroad and has achieved good results.
3. Component blood transfusion: Large amounts of frozen fresh plasma can achieve similar effects to plasma exchange. Blood transfusions may also include red blood cells, platelets, human albumin, or fresh blood as needed.
4. Liver-protecting treatment: Vitamin C, branched-chain amino acids (), adenosine triphosphate (ATP), coenzyme A, etc.
5. Corticosteroids: Short-term use to protect renal tubular epithelial cells. Hydrocortisone (200–300 mg/day) is administered intravenously.
6. Other treatments: Anticoagulants and H2 receptor blockers are used to maintain gastric pH > to prevent stress ulcers. If diuretics are ineffective due to renal failure, dialysis therapy or artificial kidney may be used. Use antibiotics with minimal impact on liver function, such as ampicillin (6–8 g/day), to prevent infections.