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| dangerous pregnancy, plump granny , fat girls xxx , fatty fatty two by four , hepatitis c, enuresis, oncology, hysterectomy, fatty fat fat , postpartum, plump sex , alcoholic complications, calculators, plump asian , charity, stockton, | Progressive hepatic failure then rapidly supervenes, with the development of jaundice, generalized bleeding from coagulopathy, hypoglycemia, hepatic encephalopathy and renal failure. Such severe cases have an inexorable downhill course unless the fetus is delivered; even plump dj's then, deterioration may continue for a further 48 plump dj's to 72 hours. Laboratory features include a moderately elevated aminotransferase, which is usually around 300 IU/L but may range plump dj's from normal to 1,000 IU/L. Alkaline phosphatase and serum bilirubin are elevated. Liver biopsy reveals tiny droplets of fat (microvesicular fat) inside hepatocytes. Diagnosis requires a high degree of suspicion, as the presentation is often nonspecific. Acute fatty liver of pregnancy should be considered whenever marked nausea and vomiting develop in the third trimester of pregnancy. |
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| Acute fatty liver may be uncommon (1 in 13,328 deliveries), but is important, having a maternal mortality of 18% and fetal mortality of 23%. The etiology is unknown, but the microvesicular fat that accumulates in hepatocytes probably represents disordered intermediary fat metabolism, perhaps related to mitochondrial injury. Acute fatty liver of pregnancy almost invariably presents in the third trimester, with a peak alcoholic complications frequency around 36-37 weeks gestation. alcoholic complications Occasionally, it will become alcoholic complications apparent only after delivery. There is an association with nulliparity, twin gestations, male fetus and pre-eclampsia or eclampsia. Presentation can vary from nonspecific symptoms to fulminant hepatic failure. Nausea and vomiting with or without abdominal pain are common. Examination may reveal a tender liver. Pruritus is uncommon and would suggest the possibility of a different liver problem such as intrahepatic cholestasis of pregnancy. |
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