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Maternal mortality and severe maternal morbidity from acute fatty liver of pregnancy in the Netherlands
Authors:Dekker Ruth R  Schutte Joke M  Stekelenburg Jelle  Zwart Joost J  van Roosmalen Jos
Affiliation:a Department of Obstetrics and Gynaecology, Isala Klinieken Zwolle, Zwolle, The Netherlands
b Department of Obstetrics and Gynaecology, University Medical Center Groningen, Groningen, The Netherlands
c Department of Obstetrics and Gynaecology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
d Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
e Department of Medical Humanities, EMGO Institute for Health and Care Research VU University Medical Center, Amsterdam, The Netherlands
Abstract:

Objective

To assess maternal death and severe maternal morbidity from acute fatty liver of pregnancy (AFLP) in the Netherlands.

Study design

A retrospective study of all cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of severe maternal morbidity in the Netherlands between 2004 and 2006, in which all 98 maternity units in the Netherlands participated. Maternal mortality ratio (MMR) and incidence of severe maternal morbidity were the main outcome measures.

Results

The MMR from direct maternal mortality from AFLP was 0.13 per 100,000 live births (95% CI 0.05-0.29). The incidence of severe maternal morbidity from AFLP was 3.2 per 100,000 deliveries (95% CI 1.8-5.7).

Conclusions

AFLP is a rare condition which still causes severe maternal morbidity and in some cases mortality. Referral to a tertiary care hospital for treatment of this uncommon disease should be considered.
Keywords:Acute fatty liver of pregnancy   Maternal mortality   Maternal morbidity
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