Abstract
A 25-year-old primiparous woman was delivered of a female viable child on July 26, 1973, at full term. Immediately after delivery, she developed icterus, nausea, vomitting and oliguria with clouding of sensorium. Jaundice rapidly deepened, and she was rushed to our hospital on July 28. Because of oliguria and marked electrolyte imbalance, peritoneal dialysis was carried out immediately, which was followed by exchange transfusion using 6 liters of fresh blood. Sensorium was restore 24 hours after the start of treatment with improvement of electroencephalograms. Blood chemistry at the peak of disease included total protein of 3.8g, urea nitrogen 51mg, per 100ml, SGOT 60u. and SGPT 67u. Needle biopsy of the liver was carried out on the 28th hospital day, disclosing many fine fat droplets in the hepatocyte. The diagnosis of acute fatty liver of pregnancy was made.
This seems to the first case that has ever survived this otherwise fatal disease treated with exchange transfusion. A review of the literature is ga ven with the discussion of treatment including exchange blood transfusion.
