Chinese Hepatolgy ›› 2023, Vol. 28 ›› Issue (2): 238-241.

• Other Liver Diseases • Previous Articles     Next Articles

Effects of plasma exchange combined with low-molecular-weight heparin sodium on coagulation, liver and kidney function and pregnancy outcomes in patients with acute fatty liver of pregnancy

YUAN Xiao-li1, WANG De-qin1, XU Xiao-ying2   

  1. 1. Department of Hemodialysis Center,Haian Hospital Affiliated to Nantong University,226600, China;
    2. Department of Obstetrics and Gynecology, Haian Hospital affiliated to Nantong University,226600, China
  • Received:2022-04-05 Online:2023-02-28 Published:2023-04-10
  • Contact: YUAN Xiao-li,Email:3555713882@qq.com

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Abstract: Objective To investigate the efficacy and safety of plasma exchange (PE) combined with low-molecular-weight heparin sodium(LMWH) in the treatment of patients with acute fatty liver of pregnancy (AFLP). Methods A total of 55 AFLP patients admitted from January 2019 to December 2021 were divided into two groups. The control group was given PE and supportive treatment, and the observation group was additionally treated with LMWH. The changes of coagulation parameters, liver and renal function , pregnancy outcomes and adverse drug reactions of the two groups were observed. Results After 1 week of treatment, D-dimer and PT levels in the observation group were lower than controls (1.73±0.34)mg/ mL vs (1.91±0.42)mg/mL; (12.43±1.72)s vs (14.16±2.04)s, all P<0.05). The levels of FIB and PLT were higher in the observation group compared with the control group( (4.67±0.97)g/L vs (43.58±0.72)g/L; (118.29±9.81)×109/L vs (100.45±9.13)×109/L, all P<0.05). Serum ALT, TBIl, DBIl and Alb levels in the observation group were lower than in the control group(( 79.58±6.53)U/L vs (96.45±8.42)U/L; (82.34±7.71)μmol/L vs (97.52±8.65)μmol/L; (81.47±5.73)μmol/L vs (97.52±7.68)μmol/L, (34.82±3.78)g/L vs (32.67±3.72)g/L, all P<0.05 ). The observation group also showed significantly lower levels of Cr, UA and 24-hour urinary protein compared with the control group ((128.15±7.14)μmol/L vs (142.43±7.96)μmol/L; (227.64±11.42)μmol/Lvs (289.52±13.29)μmol/L; (2.54±0.32)g/24 h vs (2.83±0.38)g/24 h, all P<0.05). The incidences of severe birth asphyxia and DIC, postpartum hemorrhage, maternal and neonatal peripartum mortality and liver function recovery time in the observation group were significantly lower than controls(P<0.05). There was no difference in adverse reactions between the two groups (P>0.05). No serious adverse drug reactions occurred in the observation group. Conclusion PE combined with LMWH in the treatment of AFLP can improve the coagulation function, promote the recovery of liver and kidney function, result in better pregnancy outcomes, representing a safe option.

Key words: Acute fatty liver of pregnancy, Low-molecular-weight heparin sodium, Plasmapheresis, Coagulation function, Liver and kidney function, Pregnancy outcomes