Acute Fatty Liver of Pregnancy

(AFLP)

Uh-cute Fat-e Live-er of Preg-nan-see

Definition

Acute fatty liver of pregnancy (AFLP) is a rare problem that involves the buildup of fat in the liver. If it is not treated right away, it 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 problem in a certain enzyme in the mother.

Risk Factors

Things that may raise a pregnant woman’s risk are:

  • Being pregnant with more than one child
  • First pregnancy
  • Deficiency in the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) enzyme

Symptoms

Some women do not have symptoms. When they happen, they are often not specific. Most symptoms start in the third trimester.

You may have:

  • Nausea and vomiting
  • Lack of hunger
  • Headache
  • Yellow whites of the eyes and skin
  • Weight loss
  • Belly pain
  • Excess thirst
  • Increased urination

Diagnosis

You will be asked about your symptoms and health 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 ultrasound.

Treatment

Treatment will depend on the severity of your condition. The mother will need to be stabilized until the baby can be delivered.

Hospitalization

The mother’s and baby’s vital signs will be watched. This can be done in the hospital. These steps may be done to help stabilize the mother:

  • Treat high blood pressure
  • Treat low blood sugar
  • IV fluids
  • Support airway if needed
  • Blood transfusion —to help support liver function

Delivery

The liver will often return to normal after birth. This may mean delivering the baby earlier. 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 feel better from AFLP after the baby is delivered. The mother and baby will be watched in the hospital until liver values are better.

Prevention

AFLP can’t be prevented.

RESOURCES:

American Congress of Obstetricians and Gynaecologists
http://www.acog.org

March of Dimes
http://www.marchofdimes.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Society of Obstetricians and Gynecologists of Canada
http://sogc.org

REFERENCES:

Acute fatty liver of pregnancy. British Liver Trust website. Available at: http://www.britishlivertrust.org.uk/liver-information/liver-conditions/acute-fatty-liver-of-pregnancy. Accessed July 20, 2018.

Acute fatty liver of pregnancy. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115528/Acute-fatty-liver-of-pregnancy. Updated August 22, 2014. Accessed July 20, 2018.

Acute fatty liver of pregnancy. Stanford Children’s Health website. Available at: http://www.stanfordchildrens.org/en/topic/default?id=acute-fatty-liver-of-pregnancy-90-P02465. Accessed July 20, 2018.

Ko H, BSc Pharm MD, et al. Acute fatty liver of pregnancy. Can J Gastroenterol. 2006 Jan;20(1):25-30.

Liver disorders. March of Dimes website. Available at: http://www.marchofdimes.org/complications/liver-disorders.aspx. Accessed July 20, 2018.

Wakim-Fleming, J. Liver Disease in Pregnancy. Cleveland Clinic website. Available at: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/liver-disease-in-pregnancy. Published August 2010. Accessed July 20, 2018.

Last reviewed May 2018 by James Cornell, MD  Last Updated: 7/20/18