Difference Between Preeclampsia And Aflp

Preeclampsia and AFLP both represent a substantially critical maternal ailments occurring in the third trimester of pregnancy, emerging for prompt interventions even up to pregnancy termination (11). The fairly favorable maternal outcome of preeclampsia is reversed in case of liver involvement (12). HELLP syndrome is signified as the risky evolution of preeclampsia, titled with (H) for hemolysis, (EL) for elevated liver functions tests, and (LP) for low platelet counts (13). However the essential clinicolaboratory correspondence between HELLP syndrome and AFLP carries a considerable diagnostic difficulty. A debatable interconnections between the three pregnancy related disorders, had demonstrated preeclampsia/HELLP and AFLP as a continuum of one disease entity (11). Liver biopsy which is not eligible in most cases is considered the surest discriminative maneuver. Reports had mentioned antithrombin activity to be more lessened in AFLP rather than HELLP (14&15). Being pricy, genetic studies of LCHAD deficiency are inapplicable in most cases (11). Radiologically, …show more content…
The diagnosis of preeclampsia was proved by the SOMANZ guidelines of hypertensive disorders of pregnancy (table 1) (10), while diagnosis of AFLP, was based on the Swansea criteria (table 2) (3). Along her illness, our patient had exhibited 11 out of 14 items mentioned in Swansea criteria; the vomiting, abdominal pain; encephalopathy; the hyperbilirubinemia; leukocytosis >11x109/L; ascites or bright liver on ultrasound; elevated transaminases; elevated ammonia serum levels; renal impairment; and coagulopathy (PT >14 sec or APTT >34 sec) (table 3). Furthermore, the settled connection between AFLP and diabetes insipidus was strongly evident in our patient. The high levels of the undegraded enzyme: placental vasopressinase deactivates antidiuretic hormone (ADH), with subsequent polyuria and polydipsia