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2000
Volume 22, Issue 1
  • ISSN: 1573-4048
  • E-ISSN: 1875-6581

Abstract

Background

Acute Fatty Liver of Pregnancy (AFLP) is a rare obstetric condition that can lead to maternal and perinatal complications.

Aims and Objectives

This research aimed to study the pregnancy outcome in acute fatty liver of pregnancy (AFLP). In particular, this study aimed to study the clinical features of the condition and its effect on maternal and perinatal outcomes.

Materials and Methods

A retrospective analysis of seven cases diagnosed with AFLP over a span of three years was performed. The clinical records of these women were reviewed for clinical features, laboratory investigations, and maternal and perinatal outcomes.

Results

A total of 6 (85.7%) women presented during the third trimester of pregnancy. A total of 4 (57%) of them presented after 36 weeks of gestation. A total of 6 (85.7%) women presented with jaundice, and all presented with sudden onset nonspecific symptoms, including abdominal pain and vomiting. Pregnancy was terminated by cesarean section in 6 cases. Maternal mortality was noted in 6 (85.7%) of women. All six women were diagnosed with Acute kidney injury and coagulopathy. One woman had developed encephalopathy and altered sensorium. Further, 2 (28.5%) women had intrauterine fetal demise at the time of presentation, and 1 (14.3%) had an early neonatal death.

Conclusion

AFLP is a rare clinical syndrome with rapid and dramatic progression, beginning initially with non-specific symptoms and evolving into coagulopathy, acute kidney injury, and death, resulting in alarming maternal and perinatal mortality. Early diagnosis is challenging due to the non-specificity of symptoms, but crucial and prompt termination of pregnancy is the need of the hour. Nonetheless, supportive treatment and a multidisciplinary approach may significantly improve prognosis.

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2026-02-20
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References

  1. DeyM. KumarR. NarulaG.K. VadheraA. Acute fatty liver of pregnancy.Med. J. Armed Forces India201470439239310.1016/j.mjafi.2012.06.013 25382919
    [Google Scholar]
  2. PandeyC. KarnaS. PandeyV. TandonM. Acute liver failure in pregnancy: Challenges and management.Indian J. Anaesth.201559314414910.4103/0019‑5049.153035 25838585
    [Google Scholar]
  3. NaoumE.E. LeffertL.R. ChitilianH.V. GrayK.J. BatemanB.T. Acute fatty liver of pregnancy.Anesthesiology2019130344646110.1097/ALN.0000000000002597 30707120
    [Google Scholar]
  4. LiuJ. GhazianiT.T. WolfJ.L. Acute fatty liver disease of pregnancy: Updates in pathogenesis, diagnosis, and management.Am. J. Gastroenterol.2017112683884610.1038/ajg.2017.54 28291236
    [Google Scholar]
  5. TanJ. HouF. XiongH. PuL. XiangP. LiC. Swansea criteria score in acute fatty liver of pregnancy.Chin. Med. J. (Engl.)2022135786086210.1097/CM9.0000000000001821 35671185
    [Google Scholar]
  6. NelsonD.B. YostN.P. CunninghamF.G. Acute fatty liver of pregnancy: Clinical outcomes and expected duration of recovery.Am. J. Obstet. Gynecol.20132095456.e1456.e710.1016/j.ajog.2013.07.006 23860212
    [Google Scholar]
  7. GaoQ. QuX. ChenX.K. ZhangJ.C. LiuF. TianS.C. WangC.T. Outcomes and risk factors of patients with acute fatty liver of pregnancy: A multicentre retrospective study.Singapore Med. J.201859842543010.11622/smedj.2018001 29297090
    [Google Scholar]
  8. ChangL. WangM. LiuH. MengQ. YuH. WuY. ZhuY. Pregnancy outcomes of patients with acute fatty liver of pregnancy: A case control study.BMC Pregnancy Childbirth202020128210.1186/s12884‑020‑02980‑2 32393199
    [Google Scholar]
  9. GaoQ. MaY. ZhangJ. ChenX. LiuF. TianS. QuX. Risk factors assessment in patients with acute fatty liver of pregnancy treated without plasma exchange or renal replacement therapy.J. Matern. Fetal Neonatal Med.202235112036204010.1080/14767058.2020.1777267 32519920
    [Google Scholar]
  10. WeiQ. ZhangL. LiuX. Clinical diagnosis and treatment of acute fatty liver of pregnancy: A literature review and 11 new cases.J. Obstet. Gynaecol. Res.201036475175610.1111/j.1447‑0756.2010.01242.x 20666940
    [Google Scholar]
  11. WhiteM. HanH. KhungarV. Acute fatty liver disease of pregnancy.Clin. Liver Dis. (Hoboken)2024231e014510.1097/CLD.0000000000000145 38487350
    [Google Scholar]
  12. LiuG. ShangX. YuanB. HanC. WangY. Acute fatty liver of pregnancy: Analysis on the diagnosis and treatment of 15 cases.J. Reprod. Med.2016615-6282286 27424373
    [Google Scholar]
  13. MengZ. FangW. MengM. ZhangJ. WangQ. QieG. ChenM. WangC. Corrigendum: Risk factors for maternal and fetal mortality in acute fatty liver of pregnancy and new predictive models.Front. Med. (Lausanne)2021878639510.3389/fmed.2021.786395 34738010
    [Google Scholar]
  14. ZhongY. ZhuF. DingY. Early diagnostic test for acute fatty liver of pregnancy: A retrospective case control study.BMC Pregnancy Childbirth202020116210.1186/s12884‑020‑2787‑4 32171284
    [Google Scholar]
  15. ZikiE. BopotoS. MadziyireM.G. MadziwaD. Acute fatty liver of pregnancy: A case report.BMC Pregnancy Childbirth201919125910.1186/s12884‑019‑2405‑5 31331287
    [Google Scholar]
  16. de Vasconcelos GasparA. AscensãoT.C. Santos SilvaI. Acute fatty liver of pregnancy: Rare, but potentially fatal.Am. J. Case Rep.202021e92112210.12659/AJCR.921122 31992686
    [Google Scholar]
  17. NaothavornW. ThanapongpibulC. SriudompornK. RuangkitC. SrivanitchapoomN. TungtrongchitrN.A. 24-year-old woman presenting in the third trimester of pregnancy with nausea, vomiting, and abdominal pain and diagnosed with acute fatty liver of pregnancy.Am. J. Case Rep.202223e93708510.12659/AJCR.937085 35999773
    [Google Scholar]
  18. AdemiluyiA. AmakyeD.O. JacksonN. BettyS. Acute fatty liver of pregnancy.Am. J. Case Rep.202122e93325210.12659/AJCR.933252 34839346
    [Google Scholar]
  19. Zagaceta TorresW. Quiroz LeyvaJ.J. Acute fatty liver of pregnancy in a peruvian pregnant woman: A case report.Rev. Gastroenterol. Peru2020401808410.47892/rgp.2020.401.1036 32369472
    [Google Scholar]
  20. NelsonD.B. ByrneJ.J. CunninghamF.G. Acute fatty liver of pregnancy.Clin. Obstet. Gynecol.202063115216410.1097/GRF.0000000000000494 31725416
    [Google Scholar]
  21. QinX. ChenX. YaoL. WangJ. LinL. Progress in the treatment of acute fatty liver of pregnancy and management of perioperative anesthesia review.Gynecology and Obstetrics Clinical Medicine202332828710.1016/j.gocm.2023.04.002
    [Google Scholar]
  22. RamanathanR. IbdahJ.A. Mitochondrial dysfunction and acute fatty liver of pregnancy.Int. J. Mol. Sci.2022237359510.3390/ijms23073595 35408956
    [Google Scholar]
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  • Article Type:
    Research Article
Keyword(s): Acute fatty liver; acute kidney injury; coagulopathy; encephalopathy; jaundice; pregnancy
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