Characteristics of ascites in patients with pregnancy-specific liver diseases

The characteristics of ascites in patients with pregnancy-specific liver disease (PsLD), which comprise acute fatty liver of pregnancy, hemolysis, increased levels of liver enzymes, low platelet syndrome, and preeclampsia-associated liver dysfunction, are unknown. We evaluated the cellular and biochemical characteristics, and model for end-stage liver disease scores, in patients with PsLD.

We evaluated 46 consecutive patients with PsLD for the presence of ascites. We assessed cellular and biochemical characteristics of the ascites fluid from these patients.

Ascites was observed in 35 of 46 patients with PsLD (76%). In 25 patients tested (71.4%), the ascites fluid had low levels of albumin (<0.2 g/dL) and protein (<1 g/dL) and high serum ascites albumin gradients, indicating portal hypertension. Spontaneous bacterial peritonitis was observed in 48% of patients tested and was not associated with mortality. Patients with ascites had significantly low serum levels of protein and albumin (P < .001). Model for end-stage liver disease scores did not differ between patients with or without ascites (32 vs 27; P = .1).

Ascites occur in 76% of women with PsLD, is transient, and has characteristics of portal hypertension, based on high serum ascites albumin gradients. Almost half of patients with PsLD develop spontaneous bacterial peritonitis, which does not affect survival.