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Case Reports in Critical Care
Volume 2013, Article ID 507169, 3 pages
Case Report

Hyperammonemia: A Report of Maternal Biliary Cirrhosis and Neonatal Outcome

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Parkland Health and Hospital System, 5323 Harry Hines Boulevard, Dallas, TX 75390-9032, USA

Received 28 November 2012; Accepted 13 January 2013

Academic Editors: W. S. Park, M. Podbregar, and S. K. Sinha

Copyright © 2013 Deana J. Hussamy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Although uncommon during pregnancy, cirrhosis results in multiple medical complications impacting both mother and fetus. Previous reports suggest liver dysfunction in pregnancy causes accumulation of neurotoxins within the maternal compartment that increases neonatal morbidity through placental transfer. We present a case of a 36-year-old G2P1 female with history of biliary cirrhosis presenting at 32-weeks' gestation with hepatic congestion progressing to hepatic encephalopathy prompting delivery. Umbilical cord sampling and postnatal infant testing demonstrated elevated ammonia levels which resolved by 12 hours of life without intervention. At discharge, the infant did not demonstrate evidence of neurologic deficit. We conclude that acute maternal hepatic encephalopathy and hyperammonemia due to chronic liver disease do not portend adverse neonatal outcomes, notably encephalopathy.