Overview: Acute Fatty Liver of Pregnancy (AFLP) is a rare but potentially life-threatening condition that usually occurs in the third trimester. It causes severe liver dysfunction due to fat accumulation.
Causes
- Defects in mitochondrial fatty acid beta-oxidation
- Often linked to fetal LCHAD enzyme deficiency
Risk Factors
- First pregnancy
- Multiple pregnancies (twins, triplets)
- History of preeclampsia or hypertension
Pathophysiology
- Impaired fatty acid metabolism
- Accumulation of microvesicular fat in liver cells
- Leads to liver dysfunction and metabolic imbalance
Signs & Symptoms
- Persistent nausea and vomiting
- Severe fatigue and jaundice
- Upper right abdominal pain
- Polyuria (frequent urination) and polydipsia (excessive thirst)
- Rapidly worsening condition
Complications
- Liver failure and coagulopathy (bleeding disorders)
- Hypoglycemia and kidney dysfunction
- High risk to mother and baby if untreated
Diagnosis
- Blood tests: elevated liver enzymes, low blood sugar, coagulation issues
- Ultrasound may show fatty liver changes
Management
- Immediate delivery of the baby
- ICU monitoring and supportive care
- Correction of electrolytes and glucose
Prevention
- Genetic counseling for families with LCHAD deficiency
- Early monitoring in high-risk pregnancies
- Prompt recognition of warning symptoms
Prognosis
- Most mothers recover within days after delivery
- Early diagnosis greatly improves survival
