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Jaundice with Hepatorenal Failure Associated with Pregnancy or Gynologic Procedures

Department of Obstetrics and Gynecology and The Renal Unit of The Jewish Hospital and Medical Center of Brooklyn and the Department of Obstetrics and Gynecology of The State University of New York, Downstate Medical Center.

Abstract

Jaundice associated with oliguria and azotemia also known as "hepatorenal syndrome," may occur during pregnancy or follow the performance of a gynologic operative procedure. The development of this serious complication is usually unexpected, and often fatal. Five patients who developed this syndrome are reported. Massive liver necrosis secondary to either unrecognized incubating viral hepatitis or to a hepatotoxic anesthestic agent was the cause of the "hepatorenal syndrome" in 3 of the patients. The remaining 2 were examples of "acute fatty liver of pregnancy," an entity of unknown etiology. Treatment is largely supportive; mortality is high but recovery is possible.