viernes, 24 de julio de 2015

Avances en la comprensión y el tratamiento de las enfermedades del hígado durante el embarazo: Una revisión.

Avances en la comprensión y el tratamiento de las enfermedades del hígado durante el embarazo: Una revisión.
Advances in understanding and treating liver diseases during pregnancy: A review.
Kamimura K, Abe H, Kawai H, Kamimura H, Kobayashi Y, Nomoto M, Aoyagi Y, Terai S.
World J Gastroenterol. 2015 May 7;21(17):5183-90. doi: 10.3748/wjg.v21.i17.5183.
Abstract
Liver disease in pregnancy is rare but pregnancy-related liver diseases may cause threat to fetal and maternal survival. It includes pre-eclampsia;eclampsia; haemolysis, elevated liver enzymes, and low platelets syndrome; acute fatty liver of pregnancy; hyperemesis gravidarum; and intrahepatic cholestasis of pregnancy. Recent basic researches have shown the various etiologies involved in this disease entity. With these advances, rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival. The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention. Therefore, correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis. Therefore, here we review and summarized recent advances in understanding the etiologies, clinical courses and management of liver disease in pregnancy. This information will contribute to physicians for diagnosis of disease and optimum management of patients.
KEYWORDS: Acute fatty liver of pregnancy; Haemolysis elevated liver enzymes; Hyperemesis gravidarum; Intrahepatic cholestasis of pregnancy; Liver injury; Low platelets; Pregnancy
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Hepatopatías relacionadas al embarazo
Pregnancy-related liver disorders.
Goel A, Jamwal KD, Ramachandran A, Balasubramanian KA, Eapen CE.
J Clin Exp Hepatol. 2014 Jun;4(2):151-62. doi: 10.1016/j.jceh.2013.03.220. Epub 2013 Mar 16.
Abstract
Pregnancy-related liver disorders accounted for 8% of all maternal deaths at our center from 1999 to 2011. Of the three pregnancy-related liver disorders (acute fatty liver of pregnancy (AFLP), HELLP (Hemolysis, elevated liver enzymes, low platelets) syndrome and pre-eclamptic liver dysfunction, which can lead to adverse maternal and fetal outcome, AFLP is most typically under - diagnosed. Risk of maternal death can be minimised by timely recognition and early/aggressive multi-specialty management of these conditions. Urgent termination of pregnancy remains the cornerstone of therapy for some of these life threatening disorders, but recent advancements in our understanding help us in better overall management of these patients. This review focuses on various aspects of pregnancy-related liver disorders.
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