CLINICO-MORPHOLOGICAL CHARACTERISTICS OF ACUTE FATTY LIVER OF PREGNANCY
- Авторы:Erkin Abdukhalimovich Eshbaev, Odiljon Khadjakbarovich Mirzamukhamedov , Nigora Khudayberdiyevna Kholieva , Kadriddin Shuhrat ugli Sayfiddin Khoji , Eshonkhodjaeva Madinakhon Otabek kizi
- Дата публикации:July 28, 2025
- Тип:Статья
- DOI: 10.64156/mju.8180 Скопировано
- Том / № Выпуска:№3_1_2025
Аннотация
Abstract
Aim of the study. To study the clinical and morphological changes of fatal liver damage in acute fatty hepatosis of the liver (AFH) in pregnant women.
Materials and methods. A 26-year-old pregnant woman with gestosis, anemia, and duodenal ulcer was taken. At the 24th week of pregnancy, the first pre-icteric stage of AFLP was diagnosed against the background of gradually developing gestosis. Clinically, symptoms such as weakness, lethargy, nausea, vomiting, abdominal discomfort and pain were observed. At the 25th week of pregnancy, the next stage of AFLP developed, characterized by severe jaundice, nausea, repeated gastrointestinal bleeding, post-hemorrhagic anemia, and disseminated intravascular coagulation syndrome (DIC), which ultimately led to death. Histological sections were deparaffinized and stained with hematoxylin and eosin for microscopic examination.
Conclusion. This study presents a clinico-morphological analysis based on autopsy of a mother who died of acute fatty liver disease (AFLD) during pregnancy. In the pre-icteric stage, clinical signs such as weakness, fatigue, nausea, vomiting, abdominal discomfort and pain were associated with diffuse microvesicular fat accumulation. In the second (icteric) stage, pathological morphological changes in the liver — diffuse fatty degeneration, necrobiota of nuclear structures, sinusoidal congestion and focal diapedetic hemorrhages — were more pronounced. In this stage, degenerative and necrotic processes spread to other parenchymal organs, for example, microvesicular fatty degeneration of the renal tubular epithelium and the subendocardial zone of the myocardium.
Keywords: pregnancy, gestosis, hepatosis, asymptomatic fatty liver degeneration, maternal mortality.
Annotatsiya Tadqiqot maqsadi. Homilador ayollarda jigarning o’tkir yog’li gepatozi (HJO‘YoG)da o’limga olib keladigan jigar zararlanishining klinik-morfologik o’zgarishlarini o’rganish.
Materiallar va usullar. Gestoz, anemiya va o’n ikki barmoqli ichakning oshqozon yarasining kasalligi bilan og’rigan 26 yoshli homilador ayol olingan. Homiladorlikning 24-haftasida asta-sekin rivojlanayotgan gestoz fonida AFLP ning birinchi pre-ikterik bosqichi tashxisi qo’yilgan. Klinik jihatdan zaiflik, letargiya, ko’ngil aynishi, qusish, qorin bo’shlig’idagi noqulaylik va og’riq kabi alomatlar kuzatildi. Homiladorlikning 25-haftasida AFLP ning keyingi bosqichi rivojlanib, og’ir sariqlik, ko’ngil aynishi, takroriy oshqozon-ichakdan qon ketish, post-gemorragik anemiya va tarqalgan tomir ichidagi koagulyatsiya sindromi (DIC) bilan tavsiflanadi, natijada o’limga olib keldi. Gistologik bo’limlar deparafinizatsiya qilindi va mikroskopik tekshirish uchun gematoksilin va eozin bilan bo’yaldi. Xulosa. Ushbu ishda homiladorlik paytida o‘tkir yog‘li jigar distrofiyasi (O‘YJD) natijasida vafot etgan ona autopsiyasi asosida o’tkazilgan kliniko‑morfologik tahlil taqdim etilgan. Pre‑ikterik bosqichda kuchsizlanish, holsizlik, ko’ngil aynishi, qayt qilish, qorinning noqulayligi va og‘rig‘i kabi klinik belgilar diffuz mikrovezikulyar yog‘ to‘planishi bilan bog‘liq edi. Ikkinchi (ikterik) bosqichda jigar patologik morfologik o‘zgarishlari – diffuz yog‘li degeneratsiya, yadroviy tuzilmalar nekrobioti, sinusodal kongestsiya va fokal diapedetik qon ketishlar ko‘proq aniqlangan. Bu bosqichda degenerativ va nekrotik jarayonlar boshqa parenximatoz organlarga, masalan, buyrak naycha epitelining mikrovezikulyar yog‘li degeneratsiyasi va miokardiumning subendokardial zonasiga tarqalgan. Kalit so‘zlar: homiladorlik, gestoz, gepatoz, simptomsiz yog‘li jigar degeneratsiyasi, maternal mortalitet.
References
- Bashmakova N.V., Pungina M.Yu., Erofeev E.N. Intrahepatic cholestasis of pregnancy – a predictor of cholelithiasis? // Russian bulletin of the obstetrician-gynecologist. – 2012. – №3. – P. 75-78. [Bashmakova N.V., Pungina M.Ju., Erofeev E.N. Rossijskij vestnik akushera-ginekologa. The Russian bulletin of the obstetrician-gynecologist. – 2012. – N3. – P. 75-78. (in Russian)]
- Gorshkova Z.A. Intrahepatic cholestasis of pregnancy // Medicus Amicus. – 2008. – №5. – P. 2-3. [Gorshkova Z.A. Medicus Amicus. Medicus Amicus. – 2008 – N5. – P. 2-3. (in Russian)]
- Duduk N.I., Kravchuk R.I., Zimatkin S.M. Morphofunctional changes in the liver and the possibility of their correction in the offspring of rats with cholestasis // Morphology. – 2015. – Vol. 147, No. 1. – P. 48-53. [Duduk N.I., Kravchuk R.I., Zimatkin S.M. Morfologija. Morphology. – 2015 – T.147, N1. – P. 48-53. (in Russian)]
- Zhmurovskaya L.S., Rogacheva T.A., Yurovsky N.N. Use of Ursosan in high cytolysis of hepatocytes in patients with acute viral hepatitis // Medical news. – 2004. – No. 2. – P. 62-65. [Zhmurovskaja L.S., Rogachjova T.A., Jurovskij N.N. Medicinskie novosti. Medical News. – 2004. – N2. – P. 62-65. (in Russian)]
- Klyuchaeva A.A., Vavilova L.V. Intrahepatic cholestasis of pregnancy // Healthcare. – 2007. – p. 234
- Kuzmin V.N., Serobyan A.G. Acute fatty hepatosis of pregnancy, Moscow, Med. University, Dynasty Publishing House, 2007, no. 6, pp. 82-87
- Palgova, L. K. Liver diseases associated with pregnancy: Clinical guidelines of the Society of Obstetricians and Gynecologists of St. Petersburg and the Northwestern Federal District and the St. Petersburg Society of Gastroenterologists, Hepatologists and Nutritionists / L. K. Palgova, E. V. Mozgovaya, N. V. Zhestkova, E. K. Aylamazyan "ed." - St. Petersburg: Eco-Vector, 2017. - 47 p.