Acute Fatty Liver of Pregnancy

(AFLP)

How to Say It: Uh-cute Fat-e Live-er of Preg-nan-see

Definition

Acute fatty liver of pregnancy (AFLP) is a rare 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 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
  • A problem with the long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) enzyme

Symptoms

Some women do not have symptoms. Those who do have problems that are not specific. Most symptoms start in the third trimester.

Problems may be:

  • Nausea and vomiting
  • Lack of hunger
  • Headache
  • Yellowing of the skin and whites of the eyes
  • 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.

Tests that may be done are:

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

Images may be taken to check liver size. This can be done with ultrasound.

Treatment

The only way to cure this condition is to deliver the baby. The decision to do so depends on how many weeks along a woman is in her pregnancy. Labor may happen on its own or it may be started by the doctor. Liver function will return to normal after delivery.

Prevention

There are no guidelines to prevent this problem.

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 disease of pregnancy. British Liver Trust website. Available at: http://www.britishlivertrust.org.uk/liver-information/liver-conditions/acute-fatty-liver-of-pregnancy. Accessed October 27, 2020.

Acute fatty liver of pregnancy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-fatty-liver-of-pregnancy. Accessed October 27, 2020.

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 October 27, 2020.

Bacq Y. Liver diseases unique to pregnancy: a 2010 update. Clin Res Hepatol Gastroenterol. 2011 Mar;35(3):182-193.

Intrahepatic cholestasis of pregnancy. March of Dimes website. Available at: http://www.marchofdimes.org/complications/liver-disorders.aspx. Accessed October 27, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 10/27/2020