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Case Reports in Obstetrics and Gynecology
Volume 2013, Article ID 615975, 5 pages
http://dx.doi.org/10.1155/2013/615975
Case Report

Plasmapheresis in Acute Fatty Liver of Pregnancy: An Effective Treatment

1Golestan Research Center of Gastroenterology and Liver Diseases, Golestan University of Medical Sciences, Gorgan 3711454567, Iran
2Clinical Research Development Center, Qom University of Medical Sciences, Qom 3719964797, Iran

Received 24 December 2012; Accepted 9 January 2013

Academic Editors: A. Digesu and A. D. Hull

Copyright © 2013 Mohammad Reza Seyyed Majidi and Jamshid Vafaeimanesh. 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.

Abstract

Acute fatty liver of pregnancy (AFLP) is an idiopathic disorder with an unknown cause occurring in late pregnancy. The treatment in these patients is often immediate termination of pregnancy, and plasmapheresis provides an effective treatment option. In this paper, we introduce three pregnant women treated with plasmapheresis. The first case was a 22-year-old primigravida woman treated with 22 sessions of plasmapheresis due to AFLP, hepatic and renal failure, coagulopathy, and ventilator-dependent respiratory failure. The second case was a 23-year-old woman in her second pregnancy treated with 4 plasmapheresis sessions due to AFLP, hepatic and renal failure, coagulopathy, and hypoglycemia. The third patient was a 23-year-old primigravida woman treated with 3 plasmapheresis sessions due to AFLP, renal failure, and coagulopathy. Plasmapheresis can be a life-saving treatment in patients with AFLP and is strongly recommended for patients with severity of their disease accompanied by other organ disorders. In addition, shortening the time interval between the termination of pregnancy and initializing plasmapheresis improves the outcome and reduces the duration of hospital stay and sessions of plasmapheresis.