Abstract
BackgroundAcute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention.Case presentationWe report a case of AM, an 18 year patient, in her first pregnancy at 35 weeks gestation who presented with nausea, vomiting and jaundice. She had a vaginal delivery following spontaneous preterm labour. A clinical diagnosis of acute fatty liver of pregnancy was made on the 3rd day post-delivery. The post-delivery course was complicated by a deterioration of clinical symptoms with worsening hepatorenal function and development of encephalopathy. The patient died 3 days after admission and the diagnosis was confirmed on post-mortem and histology.ConclusionDelay in the diagnosis is associated with morbid complications with high mortality and this case highlights the importance of a high index of suspicion of the condition in women presenting with jaundice in pregnancy.
Highlights
Acute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period
Delay in the diagnosis is associated with morbid complications with high mortality and this case highlights the importance of a high index of suspicion of the condition in women presenting with jaundice in pregnancy
AFLP is a disease of the third trimester that is unique to human pregnancy and was described by Sheehan in 1940 [1]
Summary
AFLP is a disease of the third trimester that is unique to human pregnancy and was described by Sheehan in 1940 [1]. Case presentation An 18 year old primiparous with an estimated gestational age (EGA) of 35 weeks and 6 days presented to the hospital as a referral from a local clinic in preterm labour. She had been generally unwell for 4 days prior to presentation and reported that she had nausea, vomiting and yellowing of the eyes for the same duration with no pruritus. High power microscopic appearance of the liver showing a dual picture of macro and micro vesicular steatosis characterized. Macro and Micro vesicular steatosis is sometimes seen in acute fatty liver of pregnancy. No cholestasis or necrosis is seen and there is minimal inflammation
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