Publication

Abstract : Background: AFLP is a rare, life-threatening pregnancy associated disorder manifesting in the late trimester or early postpartum period. Early diagnosis and treatment is very important due to multi organ involvement and high mortality.Method: Ours is a retrospective case study of AFLP in Amrita Institute of Medical Sciences &Research Centre, Kochi during the 2years of september 2013 to august 2015.Clinical presentations and management details were extracted from records.Results: Out of 6 cases, 5 were primi and 1 mutigravida. The mean gestational age of diagnosis was 36.67 weeks. The clinical features were vomiting in 2,jaundice in 5, pruritus in 2,encephalopathy in 2.Ultrasonography were done in all the 6 cases . Fatty liver in 3, ascites in 6 and bright liver were seen in 2. Labor induction with vaginal delivery in 1 and 5 had Caesarean delivery under general anaesthesia.The post op complications were acute renal insufficiency in 5 , liver failure in 3, pancreatitis in 1, metabolic acidosis in 5 ,pleural effusion in 3, pulmonary edema in 5, pneumonia in 2, sepsis in 5,hypoglycemia in 3, DIC in 3 , ARDS in 3, MODS in 3, maternal mortality in 3 and perinatal mortality in 1. Ventilatory support were given in 5 and ionotropes were used in 3. Blood & blood products were given in 5. The average duration of stay in the hospital and ICU were 12.7days and 4.8 days respectively.Conclusion: AFLP, a rare pregnancy related conditon with multi-organ failure and increased maternal and neonatal mortality. Aggressive management which includes maternal stabilization, rapid termination of pregnancy and intensive care support with multidisciplinary approach is important in reducing the complications associated with it.