European journal of obstetrics, gynecology, and reproductive biology · 2019
Utility of MELD scoring system for assessing the prognosis of acute fatty liver of pregnancy.
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Li Ping, Lin Shuo, Li Ling, Cui Jinhui, Wang Qingqing, Zhou Shuisheng, Fan Jianhui
Аннотация
OBJECTIVE: To evaluate the value of Model for end-stage liver disease (MELD) in assessing the prognosis of acute fatty liver of pregnancy (AFLP).
STUDY DESIGN: This was a retrospective study. From January 2010 to July 2018, data of 53 women diagnosed with AFLP in the third affiliated hospital of Sun Yat-Sen University were collected. Blood samples were collected on admission and MELD score was calculated. The MELD score was calculated by using the original MELD formula as shown: 9.57 log (creatinine) + 3.78 log (bilirubin) + 11.20 log (international normalized ratio, INR) + 6.43. The perinatal outcomes were documented.
RESULTS: Nine women were excluded as they were transfered to our hospital after delivery in other hospitals. The remaining 44 women had average age of 28.8 ± 5.2 years. The MELD score showed good performance in predicting most of the perinatal complications of AFLP with all the area under the receiver operating characteristic (ROC) curves (AUC) > 0.8, including ascites (AUC: 0.91, 95% CI: 0.78-0.98), wound seroma (AUC: 0.91, 95% CI: 0.78-0.93), hepatic encephalopathy (AUC: 0.93, 95% CI: 0.82-0.99), DIC (AUC: 0.87, 95% CI: 0.74-0.95), sepsis (AUC: 0.93, 95% CI: 0.82-0.99), renal insufficiency (AUC: 0.94, 95% CI: 0.82-0.99) and stillbirth (AUC: 0.85, 95% CI: 0.71-0.94). Nearly all the maternal complications were more frequently happened in MELD score ≥30 group (P < 0.05).
CONCLUSION: MELD scoring system may be a suitable method for assessing the prognosis of AFLP.
STUDY DESIGN: This was a retrospective study. From January 2010 to July 2018, data of 53 women diagnosed with AFLP in the third affiliated hospital of Sun Yat-Sen University were collected. Blood samples were collected on admission and MELD score was calculated. The MELD score was calculated by using the original MELD formula as shown: 9.57 log (creatinine) + 3.78 log (bilirubin) + 11.20 log (international normalized ratio, INR) + 6.43. The perinatal outcomes were documented.
RESULTS: Nine women were excluded as they were transfered to our hospital after delivery in other hospitals. The remaining 44 women had average age of 28.8 ± 5.2 years. The MELD score showed good performance in predicting most of the perinatal complications of AFLP with all the area under the receiver operating characteristic (ROC) curves (AUC) > 0.8, including ascites (AUC: 0.91, 95% CI: 0.78-0.98), wound seroma (AUC: 0.91, 95% CI: 0.78-0.93), hepatic encephalopathy (AUC: 0.93, 95% CI: 0.82-0.99), DIC (AUC: 0.87, 95% CI: 0.74-0.95), sepsis (AUC: 0.93, 95% CI: 0.82-0.99), renal insufficiency (AUC: 0.94, 95% CI: 0.82-0.99) and stillbirth (AUC: 0.85, 95% CI: 0.71-0.94). Nearly all the maternal complications were more frequently happened in MELD score ≥30 group (P < 0.05).
CONCLUSION: MELD scoring system may be a suitable method for assessing the prognosis of AFLP.