Abstract
Acute fatty liver disease of pregnancy has universally high fatality rate. But with modern treatment and early anticipation of diagnosis and complication, and with appropriate supportive management it has improved prognosis.
Highlights
Acute fatty liver disease of pregnancy has universally high fatality rate (1)
Jaundice, hepatic encephalopathy, ascites, hypoglycemia, and a mild to moderate elevation of transaminase levels are the key features of Acute fatty liver of pregnancy (AFLP) rather than HELLP (4)
Developing ARDS, disseminated intravascular coagulation (DIC), Hepato Renal Syndrome (HRS) and encephalopathy strengthen the diagnosis of AFLP
Summary
Acute fatty liver disease of pregnancy has universally high fatality rate (1). AFLP known as acute hepatosis of pregnancy/ acute yellow atrophy of the liver (3) It is usually a diagnosis of exclusion and a strong index of suspicion can lead to timely diagnosis. Liver biopsy is the gold standard for diagnosing AFLP, but due to the presence of coagulation abnormalities diagnosis is usually made by clinical and laboratory findings (4). Even though pathophysiology is unknown it is believed to be caused by microvascular stetosis of liver cells due to impaired long chain fatty acids metabolism in mitochondria of the fetus (2,5). It affects mainly first pregnancy, thin patients and multiple pregnancies and male fetus (4,5).
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