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David G. Conaster, MD; Robert E. Harris, MD, PhD
Wilford Hall USAF Medical Center Lackland Air Force Base, Tex

JAMA. 1975;232(11):1125-1126.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Cano et al provide in their recent article (231:159, 1975) an excellent description of the course of acute fatty liver of pregnancy. Their experience supports the previous report by Dr. Holzbach (Obstet Gynecol 43:740, 1974) of the association of acute fatty liver of pregnancy with disseminated intravascular coagulation (DIC).

We must disagree with the implication in the closing paragraph that prompt recognition and treatment of the DIC might improve the prognosis. It is clearly stated in one of the authors' references (Acta Med Scand, suppl 444, 1966), and by Holzbach, that the only chance for both mother and child is therapeutic cesarean section as early as possible after the onset of acute fatty liver symptoms. If this is done, the DIC will probably resolve spontaneously. Treatment with heparin may improve the prognosis if used in conjunction with expeditious delivery, but as the only treatment, especially in the . . . [Full Text PDF of this Article]

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