A 38-year-old woman at 34 weeks’ gestation is admitted to the ICU with altered mental status and jaundice. Right upper quadrant ultrasound reveals a fatty liver.
Which of the following is the most appropriate therapeutic intervention?
A. Ursodeoxycholic acid
B. Cholestyramine
C. Magnesium sulfate
D. Delivery of the fetus
与HELLP综合征（溶血、肝功能升高、血小板计数降低）和重度子痫前期的鉴别可能需要肝活检。急性脂肪肝与肝功能障碍有关，包括合成功能。氨和转氨酶水平较高，低血糖较多，常见弥散性血管内凝血。首选的治疗方法是胎儿娩出和支持治疗。熊去氧胆酸适用于治疗妊娠期肝内胆汁淤积症。
References:
- Rahman TM, Wendon J. Severe hepatic dysfunction in pregnancy. QJM. 2002 Jun;95(6):343-357.
- Ibda JA. Acute fatty liver of pregnancy: an update on pathogenesis and clinical implications. World J Gastroenterol. 2006;12:7397-7404.
- Chen H, Yuan L, Tan J, Liu Y, Zhang J. Severe liver disease in pregnancy. Int J Gynaecol Obstet. 2008 Jun;101(3):277-280.
D
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