Perinatology.  2020 Jun;31(2):94-98. 10.14734/PN.2020.31.2.94.

Use of the Molecular Adsorbent Recirculating System in Acute Fatty Liver of Pregnancy: a Case Report

Affiliations
  • 1Departments of Obstetrics and Gynecology, Jeonbuk National University Medical School, Jeonju, Korea
  • 2Departments of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School, Jeonju, Korea
  • 3Departments of Research Institute of Clinical Medicine, Jeonbuk National University Medical School, Jeonju, Korea

Abstract

Acute fatty liver of pregnancy (AFLP) can cause liver failure in the third trimester and lead to fatal complications of mother and fetus. Prompt delivery has been known as the best treatment but the importance of the maternal care is also considered an option for accomplishing maternal recovery. We report a case of 28 year-old nullipara with 36+1 weeks who was clinically diagnosed AFLP. Although the patient had an uneventful delivery, she was suffered from acute hepatic failure, coagulopathy, hepatic encephalopathy, postpartum hemorrhage, and renal failure. We decided to assist the patient’s liver function by using artificial liver support therapy such as molecular adsorbent recirculating system (MARS). After the intensive care with MARS and continuous renal replacement therapy, she was discharged with good condition in general. In conclusion, MARS can be a treatment option for AFLP as well as for prompt delivery. However, more studies need to be done to better understand the role of MARS in assisting liver function for AFLP.

Keyword

Acute fatty liver of pregnancy; Disseminated intravascular coagulation; Molecular adsorbents recirculating system; Postpartum hemorrhage; Renal insufficiency
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