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.
Subject(s)
Fatty Liver/epidemiology , Fatty Liver/mortality , Pregnancy Complications/epidemiology , Pregnancy Complications/mortality , Adult , Cohort Studies , Cross-Sectional Studies , Fatty Liver/physiopathology , Fatty Liver/therapy , Female , Humans , Incidence , Maternal Mortality , Morbidity , Netherlands/epidemiology , Pregnancy , Pregnancy Complications/physiopathology , Pregnancy Complications/therapy , Pregnancy Outcome , Retrospective Studies , Severity of Illness IndexABSTRACT
OBJECTIVE: We evaluated the thyroid function in women with a history of preeclampsia and/or HELLP syndrome at least 2 years after delivery. DESIGN: Observational retrospective study. SETTING: University Medical Center Groningen, The Netherlands. POPULATION: Women with a history of preeclampsia and/or HELLP syndrome (n = 310) or uncomplicated pregnancies (n = 363), between January 1990 and February 2003. METHODS: Measurement of serum thyroid stimulating hormone (TSH) levels and antibodies to thyroid peroxidase and the use of a questionnaire about relevant history and family history of auto-immune diseases related to thyroid disease. MAIN OUTCOME MEASURES: Prevalence of primary thyroid dysfunction and antibodies to thyroid peroxidase. RESULTS: Mean serum TSH values were not significantly different between the preeclampsia and control group (1.62 vs. 1.80 mU/l). The percentage of women who have (have had) hypothyroidism and hyperthyroidism, respectively, did not differ significantly between the preeclampsia and the control group (3.3 vs. 6.1% and 10.0 vs. 7.7%). Furthermore the prevalence of antibodies to thyroid peroxidase was not significantly different (6.1 vs. 7.7%). CONCLUSION: Preeclampsia and/or HELLP syndrome are not associated with an increased risk of thyroid dysfunction in later life.
