Acute fatty liver of pregnancy
- acute fatty liver of pregnancy has a rapid onset in the third trimester. It has an unknown aetiology
- there are however case reports revealing a correlation between pregnancy complications such as acute fatty liver of pregnancy and long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) deficiency in the foetus
- there are however case reports revealing a correlation between pregnancy complications such as acute fatty liver of pregnancy and long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) deficiency in the foetus
- this disease results form accumulation of microvesicular fat in hepatocytes - this condition is associated with potentially rapid onset of liver failure
- it is rare - 1 in 7000 to 1 in 16000 pregnancies. Note however that a UK study revealed a significantly higher incidence of about 1 in 1,000 pregnancies
- it is associated with raised bilirubin and transaminase levels; other possible features include hyperuricaemia, thrombocytopaenia and pancreatitis
- clinical features include vomiting, abdominal pain, and headache. The mother will be jaundiced
- disease progression may lead to renal failure, clotting disorders and hypoglycaemia
- treatment involves hospitalisation, immediate delivery, and treatment of liver failure (and renal failure). There is a high maternal and foetal mortality associated with this condition
- maternal mortality rate has been estimated at 18%, and neonatal mortality rates have ranged from 7% to 58%
Reference:
- Nelson DB, Yost NP, Cunningham FG. Acute fatty liver of pregnancy: clinical outcomes and expected duration of recovery. Am J Obstet Gynecol. 2013 Nov;209(5):456.e1-7
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