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Korean Journal of Anesthesiology 2002;43(2):249-254.
DOI: https://doi.org/10.4097/kjae.2002.43.2.249   
Anesthetic Management for an Emergency Cesarean Section in a Patient Diagnosed with Acute Fatty Liver of Pregnancy after Delivery.
Jung Ah Im, Rack Kyung Chung, Dong Youn Kim, Gui Yong Lee, Chi Hyo Kim
Department of Anesthesiology, Ewha Womans University Medical College, Seoul, Korea. rkchung@mm.ewha.ac.kr
Abstract
Acute fatty liver of pregnancy (AFLP) is a late gestational complication with clinical similarities to fulminant hepatic failure. The following case illustrates our experience with anesthesia for a cesarean section in a patient with AFLP, diagnosed after delivery. A 34-year-old woman, at 34 weeks gestation, presented in acute labor and uncontrolled gestational diabetes mellitus. She complained of a mild fever, jaundice, nausea and vomiting. Laboratory tests demonstrated an increased level of activated partial thromboplastin time, aspartate aminotransferase, and alanin aminotransferase. A cesarean section was performed under general anesthesia with O2-N2O-fentanyl-midazolam-vecuronium. After delivery, she was diagnosed as AFLP. The diagnosis was made by clinical, laboratory and an ultrasound of liver findings. After conservative treatment, she recovered and was discharged on postoperative day 16.
Key Words: Anesthesia; cesarean section; fatty liver; complication of pregnancy


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