Abstract
Introduction: Acute fatty liver of pregnancy (AFLP) is rare but potentially lethal complication. AFLP characterized by microvascular fatty infiltration of hepatocytes without any inflammation or necrosis.Case Presentation: A 37-year-old multigravida with 29 weeks period of gestation came with chief complains of acute jaundice, nausea, malaise and anorexia since 7 days ago. On examination, her eyes were icteric and her motor power was decreased on both extremities. Abdominal examination showed fetus in cephalic presentation with normal fetal heart rate. There was no opening and effacing of cervix. The ECG result showed prolonged QT interval. She had elevated liver enzyme, decreased renal function, electrolyte imbalance, hypoalbuminemia and hypercholesterolemia. Abdominal ultrasound was within normal limit. Patient was then assessed with differential diagnosed of AFLP, acute hepatitis and HELLP syndrome. She was treated conservatively with ferrous sulfate, high carbohydrate diet, KSR once daily, CDR once daily and Bisoprolol 1.25mg once daily. Â Three months later patient delivered a healthy baby boy via caesarian section due to premature rupture of membrane.Conclusion: Since AFLP is a medical and obstetric emergency, early recognition and prompt treatment improves both maternal and fetal survival.
Highlights
Acute fatty liver of pregnancy (AFLP) is rare but potentially lethal complication
Acute fatty liver of pregnancy (AFLP) is rare but A 37-year-old multigravida with 29 weeks period of potentially lethal complication which usually gestation was referred from a peripheral hospital to occur in third trimester or early postpartum our primary hospital with chief complain of acute period and may be part of a spectrum of pre- jaundice
AFLP is an example of a primary mitochondrial hepatopathy.[7]
Summary
Acute fatty liver of pregnancy (AFLP) is rare but A 37-year-old multigravida with 29 weeks period of potentially lethal complication which usually gestation was referred from a peripheral hospital to occur in third trimester or early postpartum our primary hospital with chief complain of acute period and may be part of a spectrum of pre- jaundice. Patient complained about having eclampsia related disorder.[1] AFLP is charac- nausea, malaise, anorexia and body weakness since terized by microvascular fatty infiltration of 7 days ago She could barely move her extremities hepatocytes without any inflammation or necro- since this morning. Clinical findings in AFLP may vary and overlap Abdominal examination revealed relaxed uterus of with HELLP syndrome making the diag- 28 weeks period of gestation, with fetus in cephalic nosis more challenging. In this case report, we presentation and normal fetal heart rate. The patient was assessed with differential diagnosed of AFLP, acute hepatitis and HELLP syndrome She had normal blood pressure throughout gestational and during hospital stay. Patient delivered a healthy baby boy with birth weight 3.200 gram and APGAR score of 7-8
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