CLINICO-MORPHOLOGICAL CHARACTERISTICS OF ACUTE FATTY LIVER OF PREGNANCY

Abstract

Aim of the study. To study the clinical and morphological changes of fatal liver damage in acute fatty hepatosis of the liver (AFH) in pregnant women. Materials and methods. A 26-year-old pregnant woman with gestosis, anemia, and duodenal ulcer was taken. At the 24th week of pregnancy, the first pre-icteric stage of AFLP was diagnosed against the background of gradually developing gestosis. Clinically, symptoms such as weakness, lethargy, nausea, vomiting, abdominal discomfort and pain were observed. At the 25th week of pregnancy, the next stage of AFLP developed, characterized by severe jaundice, nausea, repeated gastrointestinal bleeding, post-hemorrhagic anemia, and disseminated intravascular coagulation syndrome (DIC), which ultimately led to death. Histological sections were deparaffinized and stained with hematoxylin and eosin for microscopic examination. Conclusion. This study presents a clinico-morphological analysis based on autopsy of a mother who died of acute fatty liver disease (AFLD) during pregnancy. In the pre-icteric stage, clinical signs such as weakness, fatigue, nausea, vomiting, abdominal discomfort and pain were associated with diffuse microvesicular fat accumulation. In the second (icteric) stage, pathological morphological changes in the liver - diffuse fatty degeneration, necrobiota of nuclear structures, sinusoidal congestion and focal diapedetic hemorrhages - were more pronounced. In this stage, degenerative and necrotic processes spread to other parenchymal organs, for example, microvesicular fatty degeneration of the renal tubular epithelium and the subendocardial zone of the myocardium.