Acute fatty liver of pregnancy: a case report

BMC Pregnancy Childbirth. 2019 Jul 22;19(1):259. doi: 10.1186/s12884-019-2405-5.

Abstract

Background: Acute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention.

Case presentation: We report a case of AM, an 18 year patient, in her first pregnancy at 35 weeks gestation who presented with nausea, vomiting and jaundice. She had a vaginal delivery following spontaneous preterm labour. A clinical diagnosis of acute fatty liver of pregnancy was made on the 3rd day post-delivery. The post-delivery course was complicated by a deterioration of clinical symptoms with worsening hepatorenal function and development of encephalopathy. The patient died 3 days after admission and the diagnosis was confirmed on post-mortem and histology.

Conclusion: Delay in the diagnosis is associated with morbid complications with high mortality and this case highlights the importance of a high index of suspicion of the condition in women presenting with jaundice in pregnancy.

Keywords: Acute fatty liver of pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Clinical Deterioration
  • Delayed Diagnosis
  • Delivery, Obstetric / methods
  • Diagnosis
  • Diagnosis, Differential
  • Fatal Outcome
  • Fatty Liver* / diagnosis
  • Fatty Liver* / physiopathology
  • Fatty Liver* / therapy
  • Female
  • Humans
  • Jaundice* / diagnosis
  • Jaundice* / etiology
  • Kidney Function Tests / methods
  • Liver Function Tests / methods
  • Parity
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / physiopathology
  • Pregnancy Complications* / therapy
  • Pregnancy Trimester, Third

Supplementary concepts

  • Acute fatty liver of pregnancy