Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Acute fatty liver of pregnancy (AFLP) is a rare complication of pregnancy that involves the buildup of fat in the liver. Without prompt treatment, AFLP can lead to coma, organ failure, and death of the mother and baby.

The Liver

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Causes

The cause of AFLP is not known. It may be due to a defect in a specific enzyme in the mother.

Risk Factors

Factors that may increase a pregnant woman’s risk of AFLP include:

  • Having a multiples pregnancy—a twin, triplet, or higher order pregnancy
  • First pregnancy
  • Deficiency in the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) enzyme

Symptoms

Symptoms are usually not specific. Most symptoms begin in the third trimester and may include:

  • Nausea and vomiting
  • Lack of appetite
  • Abdominal pain
  • Headache
  • Fatigue
  • Yellowing of the whites of the eyes and skin
  • Excessive thirst
  • Increased urination

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

  • Blood tests to check liver function
  • Urine tests to look for signs of kidney damage

Images may be taken to check the size of your liver. This can be done with:

A genetic test may be done after delivery of the newborn. This will determine whether the newborn has LCHAD deficiency. LCHAD deficiency prevents the baby from converting certain fats to energy. This can result in feeding difficulties, low blood sugar, and liver problems.

Treatment

Treatment will depend on the severity of your condition but in general includes stabilizing the mother until the baby can be safely delivered.

Hospitalization and Supportive Care

After diagnosis, the mother’s and baby’s vital signs will be monitored. This often requires hospitalization. The following treatments may be needed to help stabilize the mother:

  • Treating high blood pressure
  • Treatment low blood sugar
  • IV fluids
  • Supporting airway if needed
  • Blood transfusion—to help support liver function

Delivery of the Fetus

The liver will often return to normal function after birth. This may require delivering the baby earlier than expected. Once it is safe for the baby, labor may be started by your doctor. A cesarean section may also be done in severe cases.

It will take a few days to recover from AFLP after the baby is delivered. The mother and baby will be monitored in the hospital until liver values are improved.

Prevention

There is no known way to prevent this condition as the cause is unknown. If you have LCHAD deficiency, you are at increased risk for AFLP in the future.