Utility of MELD scoring system for assessing the prognosis of acute fatty liver of pregnancy.

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.