Definition of Acute fatty liver of pregnancy
Acute fatty liver of pregnancy: Liver failure in late pregnancy, usually from unknown
cause.
Acute fatty liver of
pregnancy (AFLP) typically occurs in first-time pregnancies in the last
trimester.
AFLP causes nausea and
vomiting, abdominal pain
especially in the upper abdomen (epigastrium), jaundice (yellowing), frequent
thirst (polydipsia) and increased urination (polyuria), fatigue, headache, and altered mental
state.
Laboratory features of AFLP include profoundly low blood sugar (hypoglycemia), elevated liver
enzymes (e.g., serum transaminase activity) and low levels of platelets (cell
fragments in blood needed for clotting). The liver is infiltrated with fat.
If untreated, AFLP can cause complete liver failure, bleeding (because of
impaired blood clotting) and death of the mother and child.
AFLP is treated by delivering the baby as soon as possible. Early diagnosis
of AFLP and prompt delivery dramatically improve the outcome and the once-bleak
outlook.
Women with AFLP generally improve soon after delivery, unless the liver
damage is severe. As a general rule, AFLP does not usually recur during a
subsequent pregnancy.
However, AFLP has been found associated in some cases with an abnormality of
fatty-acid metabolism. This abnormality is a deficiency of the enzyme
long-chain-3-hydroxyacyl-CoA dehydrogenease (LCHAD). The mother (and father)
have 50% of normal LCHAD activity and the fetus has no LCHAD activity. The
metabolic disease in the baby's liver apparently causes the fatty liver disease in the mother.
In cases of AFLP due to LCHAD deficiency, there is a 25% (or greater) risk of
AFLP in each pregnancy.
Last Editorial Review: 5/17/1999 8:05:00 AMCommon Misspellings: acute fatty liver of pregnacy, acute fatty liver of pregancy, acute fatty liver of pregency, acute fatty liver of pregnanacy
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