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Hepatitis and Hepatic Failure in Pregnancy

From the Department of Obstetrics and Gynecology at the University of Mississippi School of Medicine, Jackson, Miss 39216.

Abstract

The cause of acute liver failure in a postoperative patient may be exceedingly difficult to determine. In the case presented, liver failure occurred after a cesarean-hysterectomy in a severe preeclamptic. Presentation of the case is followed by a discussion of potential causes. Those considered were toxemia of pregnancy, obstetric fatty liver, viral hepatitis, hepatotoxic drugs and anesthetic hepatitis. Analysis of the case following the discussion of potential causes incriminated halothane or cross-sensitization between halothane and methoxyflurane as the most likely cause, however, this could not be proved since no specific clinical test for halothane-induced hepatitis exists at the present time. Recommendations are made for preoperative hepatic evaluation of all patients. These may be valuable as baseline studies for future reference.