24 August 2022: Articles
A 24-Year-Old Woman Presenting in the Third Trimester of Pregnancy with Nausea, Vomiting, and Abdominal Pain and Diagnosed with Acute Fatty Liver of Pregnancy
Management of emergency care, Rare disease
Waravudh Naothavorn A , Chatsaran Thanapongpibul B , Kanin Sriudomporn B , Chayatat Ruangkit B , Nantaporn Srivanitchapoom B , Nuttapat Tungtrongchitr A*DOI: 10.12659/AJCR.937085
Am J Case Rep 2022; 23:e937085
Table 2. Clinical and obstetrical features of the case.
| Swansea Criteria | Case | |
|---|---|---|
| Age, year | 24 | |
| Gravidity, n | 2 | |
| Parity | 1 | |
| BMI of delivery, kg/m | 30 | |
| Number of gestations | 1 | |
| Fetal sex | Female | |
| (1) Vomiting | + | |
| (2) Abdominal pain | + | |
| (3) Polydipsia/polyuria | – | |
| (4) Encephalopathy | – | |
| Delivery date, week | 36 | |
| Cesarean delivery | + | |
| (5) Ascites or bright liver on ultrasound | (Postpartum day 1) – | |
| ALT – alanine aminotransferase; PTT – partial thromboplastin time; AST – aspartate aminotransferase; BMI – body mass index; BUN – blood urea nitrogen; NA – not available; PT – prothrombin time. | ||
| Biological features at admission and the cut-off point | Laboratory’s reference range | |
| (6) Total bilirubin, mg/dL (>0.8) | 0.2–1.2 | +(2.6) |
| (7) Glucose, mg/dL ( | 74–100 | +(54) |
| (8) Elevated uric acid, mg/dL (>5.7) | 2.6–6.0 | +(7.4) |
| (9) Leukocytosis, 10/L (>11) | 4.0–10.0 | +(12.59) |
| (10) Elevated transaminases | + | |
| – ALT, IU/L (>42) | 5–34 | 1,298 |
| – AST, IU/L (>40) | 0–55 | 1,413 |
| (11) Elevated blood ammonia, μg/dL (>66) | 15–51 | +(126) |
| (12) Evidence of AKI | + | |
| – Creatinine, mg/dL (>1.7) | 0.55–1.02 | 1.1 (no previous baseline) |
| – BUN, mg/dL | 7–18 | 11 |
| (13) Coagulopathy | + | |
| – PT, s (>12.5) | 9.9–12.2 | 17.7 |
| – PTT, s (>36.5) | 21.9–29.3 | 35.8 |
| – Fibrinogen level, mg/dL ( | 166.2–404.3 | 73.9 |
| (14) Liver histology with specific fat staining | NA | |
| Total number | 10 | |
| ALT – alanine aminotransferase; PTT – partial thromboplastin time; AST – aspartate aminotransferase; BMI – body mass index; BUN – blood urea nitrogen; NA – not available; PT – prothrombin time. | ||