The early recognition of AFLP cases and prompt progressive management, including early termination of pregnancy and large dose infusion of fresh frozen plasma, the prognosis of AFLP is obviously improved.

The objective of this study was to assess the incidence, prognostic factors and the outcome of obstetric patients admitted in a surgical intensive care unit (SICU) during the ante-partum or postpartum period (within 6 weeks of delivery). Between 1995 and 2002, the patients transferred from the department of obstetrics were retrospectively included into the study. Demographics included: obstetric data, medical and surgical histories, diagnosis, simplified acute physiology score (SAPS II), acute physiology and chronic health evaluation system APACHE II score; and the occurrence of organ failure, therapeutic interventions, length of stay in the SICU and outcome were recorded. During the study period, 364 obstetric patients were admitted to the SICU. Obstetric admissions to the SICU represented 0.6% of all deliveries and the SICU utilisation rate was 14.96%. The main indications for admission were eclampsia (70.6%) and postpartum haemorrhage (16.2%). The overall mortality rate was 16.7% (n = 61). In a logistic regression model, risk factors for death included organ system failure (odds ratio (OR) = 3.95 confidence interval (CI) [1.84 - 8.48], bilirubin >12 mg/l (OR = 1.017 CI [1.00 - 1.03]), and prolonged prothrombin time (OR = 0.97 CI [0.95 - 0.99]). Median length of stay was longer in non- survivors (6.5 +/- 7.3 vs 5.5 +/- 4.6 days). Maternal condition on admission and associated complications are the major determinant of maternal outcome.

ARF with eclampsia is a frequent situation that required intensive management when risks factors were present. The need for dialysis was a rare condition.

Haemodynamic alterations occur consistently with laparoscopic surgery in humans. These haemodynamic changes have never been reproduced in an animal model without additional potentiating factors. As these alterations may be deleterious in some patients and as the cause is only partly understood, we have used an animal model to study these changes. Pneumoperitoneum with intraperitoneal pressures of up to 15 mm Hg were produced in pigs, in the same way as for laparoscopic surgery in humans. Arterial pressure, cardiac output, pulmonary arterial pressure and systemic arterial resistance were assessed at baseline and after pneumoperitoneum had been produced. Intraperitoneal pressures of up to 15 mm Hg were not associated with consistent circulatory changes and we conclude that haemodynamic changes associated with laparoscopic surgery are dependent on species.