What is Acute Fatty Liver of Pregnancy?

Acute fatty liver of pregnancy is a rare but serious obstetric complication that primarily occurs in the late stages of pregnancy or the early postpartum period. It is characterized by excessive accumulation of fat in the liver, leading to abnormal liver function and possibly accompanied by symptoms such as jaundice, nausea, vomiting, and abdominal pain. In severe cases, it can cause multi-organ dysfunction, including liver failure, renal failure, and coagulation disorders, posing a threat to the lives of both mother and infant. The condition typically has an abrupt onset with rapid progression and most commonly occurs between 28 to 40 weeks of gestation, especially around 35 weeks, and is more prevalent among first-time mothers. The exact cause of acute fatty liver of pregnancy is not yet fully understood but may be related to genetic factors, metabolic abnormalities, hormonal changes, and other factors. Clinical diagnosis mainly relies on medical history, symptoms, physical signs, and laboratory findings such as abnormal liver function tests, elevated blood lipids, and increased uric acid levels.

The clinical manifestations of acute fatty liver of pregnancy are varied and include persistent nausea, vomiting, fatigue, jaundice, and abdominal pain. The condition progresses rapidly and can lead to severe complications such as coagulopathy, liver failure, and renal failure, potentially endangering the lives of both mother and infant. Diagnosis can be made through detailed medical history taking, physical examination, and necessary laboratory tests such as serum bilirubin and transaminase levels, as well as imaging studies like ultrasound. Once diagnosed, pregnancy should be promptly terminated, and appropriate supportive treatment initiated.