RT Book, Section
A1 Jones, Megan
A1 McNulty, Jennifer
A2 Foley, Michael R.
A2 Strong, Jr, Thomas H.
A2 Garite, Thomas J.
SR Print(0)
ID 1152537258
T1 Acute Fatty Liver of Pregnancy
T2 Obstetric Intensive Care Manual, 5e
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9781259861758
LK obgyn.mhmedical.com/content.aspx?aid=1152537258
RD 2024/04/25
AB Acute  fatty  liver  of  pregnancy  (AFLP)  is  an  uncommon  but  potentially  fatal  complication  of  pregnancy,  which  results  in  microvesicular  fat  deposition  in  the  liver,  resulting  in  severe  liver  dysfunction.  Hallmarks  of  the  disease  include  jaundice,  coagulopathy,  and  encephalopathy.  Although  most  commonly  a  disorder  of  the  late  third  trimester,  very  rare  cases  have  been  reported  as  early  as  23  weeks.  The  incidence  of  AFLP  appears  to  have  increased  over  the  past  30  years  (from  1:15,900  to  1:6692  deliveries),  possibly  as  more  widespread  recognition  of  the  disease  and  identification  of  milder  cases  occurs.  Prior  to  the  1970s,  maternal  and  fetal  mortality  rates  were  reported  to  be  as  high  as  75%  and  85%,  respectively.  However,  recent  reports  suggest  markedly  improved  maternal  mortality,  ranging  from  0%  to  10%  and  fetal  mortality  from  8%  to  25%.  Deaths  have  been  attributed  to  bleeding  complications,  aspiration,  renal  failure,  and  sepsis.  Survivors  of  AFLP  generally  recover  without  sequelae.  Early  diagnosis  is  critical  and  AFLP  should  be  considered  in  all  pregnant  women  presenting  in  the  third  trimester  of  pregnancy  with  nausea,  vomiting,  or  epigastric  pain.