ArticleHepatology (Baltimore, Md.)2020
Acute Liver Failure (ALF) in Pregnancy: How Much Is Pregnancy Related?
Article in Hepatology (Baltimore, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Maternal and fetal outcomes in pregnant women with liver disease.Pakistan journal of medical sciences · 2026Article
- Burden and impact of acute kidney injury in acute liver failure: A systematic review.World journal of critical care medicine · 2026Article
- Exposure to Acetaminophen (Paracetamol) during Pregnancy and Childhood Cancer: A Population-Based Cohort Study in Taiwan.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Fast-track anesthesia in a pregnant female patient undergoing liver transplantation: a case report.BMC anesthesiology · 2026Article
- Risk factors for acute fatty liver of pregnancy complicated by acute liver failure: a retrospective study of 133 cases.BMC pregnancy and childbirth · 2025Article
- The C3/C3aR pathway exacerbates acetaminophen-induced mouse liver injury via upregulating podoplanin on the macrophage.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- [Acute fatty liver of pregnancy with severe coagulopathy: a case report and review].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2024Review
- Role of viral hepatitis in pregnancy and its triggering mechanism.Journal of translational internal medicine · 2024Article
- The Use and Potential Benefits of N-Acetylcysteine in Non-Acetaminophen Acute Liver Failure: An Etiology-Based Review.Biomedicines · 2024Review
- Investigating gastrointestinal disorders in pregnancy.Obstetric medicine · 2024Review
- Liver imaging and pregnancy: what to expect when your patient is expecting.Insights into imaging · 2024Review
- Key Components of Successful Management of Acute Fatty Liver of Pregnancy: A Case Report and Literature Review.Cureus · 2024Article
- Exceptional Liver Transplant Indications: Unveiling the Uncommon Landscape.Diagnostics (Basel, Switzerland) · 2024Review
- A Comprehensive Review of the Diagnosis and Management of Acute Liver Failure.Journal of clinical medicine · 2023Review
- Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review.Journal of personalized medicine · 2023Article
- Managing hepatic complications of pregnancy: practical strategies for clinicians.BMJ open gastroenterology · 2022Review
- State of the Art in Hepatic Dysfunction in Pregnancy.Healthcare (Basel, Switzerland) · 2021Review
- Comparison of maternal and neonatal outcomes between acute fatty liver of pregnancy and hemolysis, elevated liver enzymes and low platelets syndrome: a retrospective cohort study.BMC pregnancy and childbirth · 2021Article
- Viral hepatitis and pregnancy.Nature reviews. Gastroenterology & hepatology · 2021Review
- A Rare Disease Presenting Postpartum: Acute Fatty Liver of Pregnancy.Case reports in obstetrics and gynecology · 2021Article
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9 authors.
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Abstract
BACKGROUND AND
aimsAcute liver failure (ALF), characterized by sudden onset of coagulopathy (international normalized ratio [INR] ≥ 1.5) and encephalopathy, may occur during pregnancy either as a pregnancy-associated etiology or an unrelated and coincidental liver injury. The U.S. Acute Liver Failure Study Group, comprised of 33 tertiary care liver centers, has enrolled consecutive patients with ALF or acute liver injury (ALI; INR ≥ 2.0 with no encephalopathy), over two decades. APPROACH AND
resultsEtiologies, clinical features, and outcomes of 70 of 3,155 patients (2.2%) who developed ALF or ALI during pregnancy were reviewed to determine how many were pregnancy associated (pregnancy-associated liver disease; PAALD) and how many were attributed to other etiologies. Thirty-five of the 70 were considered PAALD, of whom nearly half were attributed to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and half to acute fatty liver of pregnancy (AFLP), although, in some instances, the distinction was unclear. Virtually all with PAALD had been delivered before hepatology referral, mostly by cesarean section. Acetaminophen toxicity accounted for 21 (60% of the remaining cases), with the remainder resulting from a variety of other causes, but not including viral hepatitis A through E. Although recovery with delivery or supportive measures was possible in most cases, 11 of 70 (16%) required liver transplantation and 8 (11%) died. Swansea criteria to diagnose AFLP were met by all patients with PAALD and also by virtually all women with other forms of ALF.
conclusionsOnly half of those with ALF during pregnancy appeared to have HELLP or AFLP. Morbidity and mortality for mother and fetus are strongly associated with etiology of liver failure.
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