Ashish, Goel (2009) Assessment of diagnostic criteria for acute fatty liver of pregnancy. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND : Acute fatty liver of pregnancy is a rare condition and there has been no attempt to correlate clinical diagnostic criteria and histologically proven acute fatty liver of pregnancy (AFLP). The aim of this study was to assess the accuracy of the recommended criteria in diagnosing acute fatty liver of pregnancy that was proven by histology. METHODS : A retrospective study of patients with acute liver failure in the third trimester of pregnancy was conducted. The patient group included all the patients who had undergone a liver biopsy for a suspicion of pregnancy related liver dysfunction between 1998 and 2008 and an additional group of patients in whom there was another defined cause of acute liver failure in whom no biopsy was attempted. Liver histology was reviewed by a single hepato-pathologist. The patients were classified into three groups – Group A - those in whom the liver biopsy proved that the condition was AFLP, Group B - those in whom the liver biopsy was indeterminate or inconsistent and Group C - those in whom an alternate explanation for liver failure was defined by tests other than biopsy. We tested the accepted clinical criteria for diagnosis in these three groups. RESULTS : There were 17 patients in Group A, 7 patients in Group B and 11 patients in Group C. Using Group A and C to measure sensitivity and specificity we found that the diagnostic criteria were 100% sensitive but had a low specificity. The criteria were also positive in a proportion of the small number of cases in Group B – the indeterminate group. CONCLUSION : The diagnostic criteria are an accurate way of diagnosing acute fatty liver of pregnancy with a 100% negative predictive value. Therefore these criteria are useful in making the diagnosis but do not exclude other causes, which must always be scrupulously excluded.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Acute fatty liver of pregnancy ; AFLP ; HELLP syndrome ; pre-eclampsia. |
| Subjects: | MEDICAL > Gastroenterology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 14 Jul 2017 03:54 |
| Last Modified: | 14 Jul 2017 03:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1624 |
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