Liver failure during pregnancy.

Quantitative EEG changes associated with loss and return of consciousness in healthy adult volunteers anaesthetized with propofol or sevoflorane. Validating the sedation-agitation scale with the bispectral index and visual analog scale in adult ICU patients after cardiac surgery. In vivo quantification of liver dialysis: comparison of albumin dialysis and fractionated plasma separation. Brain electrical activity mapping of EEG for the diagnosis of (sub) clinical hepatic encephalopathy in chronic liver disease. The diagnosis of subclinical hepatic encephalopathy in patients with cirrhosis using neuropsychological tests and automated electroencephalogram analysis. Comparison of changes in electroencephalographic measures during induction of general anaesthesia: influence of the gamma frequency band and electromyogram signal. This is an introduction to the Gut tutorial ''Liver failure during pregnancy'' hosted on BMJ Learning—the best available learning website for medical professionals from the BMJ Group. This module discusses the clinical management of acute liver failure occurring in pregnancy. Early recognition of possible causes and prompt treatment are crucial for successful outcome. Differentiating pregnancy-related liver dysfunction from liver dysfunction due to causes unrelated to pregnancy is often not possible clinically. Clinical criteria, used to diagnose the cause of liver dysfunction antenatally, often overlap. Clinical decision making in this setting has to be carried out within the constraints of not being able to make a precise diagnosis antenatally. If acute liver failure due to a pregnancy-related cause (such as acute fatty liver of pregnancy) is a possible differential diagnosis, urgent delivery of the baby is warranted. The association of inherited fatty acid oxidation disorders and maternal liver disease is being increasingly recognised. However, the exact mechanism of this foetal–maternal interaction is not yet known. Awareness of this association is important in providing counselling about the risk of maternal liver disease in subsequent pregnancies and deciding need for any specific therapy in the baby. To access the tutorial (Interactive Case History), click on BMJ Learning: take this module on BMJ Learning from the content box at the top right and bottom left of the online article. For more information please go to: http://gut.bmj.com/tutorials/ collection.dtl If prompted, subscribers must sign into Gut with their journal username and password. All users must also complete a one-time registration on BMJ Learning and subsequently log in (with a BMJ Learning username and password) on every visit.