What is Acute Fatty Liver of Pregnancy?

Acute fatty liver of pregnancy is a rare but serious complication that primarily occurs during late pregnancy or the early postpartum period. Its pathological features are characterized by massive deposition of fat droplets within hepatocytes, leading to a rapid decline in liver function. The exact cause of AFLP remains unclear, but it may be related to genetic factors, metabolic disorders, and hormonal changes. It typically occurs between 28 and 40 weeks of gestation, most commonly around 35 weeks, and is often seen in first-time mothers. It may also be associated with conditions such as gestational hypertension, twin pregnancies, or male fetuses.

The clinical manifestations of acute fatty liver of pregnancy are similar to those of fulminant hepatitis. In the early stages, symptoms may include persistent nausea, vomiting, fatigue, upper abdominal pain, or headache. Subsequently, jaundice may develop and progressively worsen, typically without accompanying pruritus. As the disease progresses, it can lead to severe complications such as coagulopathy, hypoglycemia, impaired consciousness, psychiatric symptoms, hepatic encephalopathy, and liver or renal failure.

The treatment principle is immediate termination of pregnancy, along with symptomatic and supportive care, including correction of electrolyte imbalances, maintenance of blood glucose levels, and prevention and treatment of infections. Severe cases may require hemodialysis or liver transplantation.