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손인숙 ( In Sook Sohn ),김지연 ( Ji Yeon Kim ),권한성 ( Han Sung Kwon ),이선주 ( Sun Ju Lee ),이지영 ( Ji Young Lee ),김수녕 ( Soo Nyung Kim ),최원혁 ( Won Hyeok Choe ),우남식 ( Nam Sik Woo ),한혜승 ( Hye Seung Han ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.12
Acute fatty liver of pregnancy is a rare but usually fatal complication of the last trimester of pregnancy. The primary therapy is early delivery and supportive care. We report two cases of favorable outcomes in acute fatty liver of pregnancy. First case was a nulliparous twin pregnant woman at 33 weeks of gestation with jaundice, abdominal pain, and diarrhea. Because the acute fatty liver of pregnancy was diagnosed by typical laboratory findings, an emergency cesarean section was performed. Then, she showed the symptoms of acute renal failure, and the laboratory findings of disseminated intravascular coagulation. Second case was a nulliparous women at 37 weeks of gestation with malaise, upper abdominal pain, and elevated transaminase level. Under the impression of the acute fatty liver of pregnancy and fetal distress, an emergency cesarean section was performed under both epidural and general anesthesia. Liver biopsy was performed and showed microvesicular fatty infiltration of hepatocyte. In spite of the literature`s dismal prognosis, our cases seemed to be favorable maternal and perinatal outcomes because of early recognition and immediate termination of pregnancy with intensive and supportive care
손인숙 ( In Sook Sohn ),김수녕 ( Soo Nyung Kim ),이지영 ( Ji Young Lee ),이선주 ( Sun Joo Lee ),권한성 ( Han Sung Kwon ),김영진 ( Young Jin Kim ),우남식 ( Nam Sik Woo ),최영숙 ( Young Sook Choi ),이홍기 ( Hong Ghi Lee ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.11
Essential thrombocythemia (ET) is a chronic myeloproliferative disease characterized by a markedly elevated platelet count in the peripheral blood due to excessive proliferation of bone marrow megakaryocytes. When the disease affects women during pregnancy, an adverse obstetric outcome is possible: miscarriages, intrauterine growth restriction, preterm delivery, intrauterine fetal death, preeclampsia. Maternal complications, both thrombotic and hemorrhagic, were reported relatively infrequently. Various treatments as acetylsalicylic acid, hydroxyurea, anagrelide, heparin, interferon-alpha and plateletpheresis have been proposed to improve the pregnancy. Our case was a 38 years old multiparous women at 37 weeks of gestation with preeclampsia, intrauterine growth restriction. Under the impression of oligohydramnios and fetal distress, an emergency cesarean section was performed under epidural anesthesia. During cesarean section, sudden cardiac arrest with unknown cause was developed, and successful resuscitation was done. After cesarean section, patient continued to elevate platelet count. So bone marrow aspiration and biopsy were performed and showed essential thrombocythemia. We report a case of essential thrombocythemia diagnosed during pregnancy with brief review of the literature.