What Is Acute Fatty Liver of Pregnancy?
Apr 25, 2022
Source: Cainiu Health
Dr. Cao Ting
Introduction
The etiology of acute fatty liver of pregnancy (AFLP) remains unclear; recovery is only possible upon termination of pregnancy. It is therefore hypothesized that AFLP results from hormonal changes induced by pregnancy, which impair fatty acid metabolism, leading to accumulation of free fatty acids in hepatocytes and other organs—including the kidneys, pancreas, and brain—and subsequently causing multi-organ dysfunction. In the early stage of AFLP, patients typically present with persistent nausea and vomiting.
Pregnancy places women in a special physiological category. If fatty liver disease develops during gestation, it can adversely affect maternal health and severely impair fetal growth and development. Therefore, pregnant women should be aware of this condition. But what exactly is pregnancy-associated fatty liver disease?
What Is Pregnancy-Associated Fatty Liver Disease?
Pregnancy-associated fatty liver disease—also known as acute fatty liver of pregnancy (AFLP), idiopathic fatty liver of pregnancy, or simply pregnancy-related fatty liver—is a rare, life-threatening condition unique to the third trimester of pregnancy. It has an abrupt onset, rapid progression, and clinical manifestations resembling those of fulminant hepatitis.
The exact etiology of AFLP remains unknown. However, recovery is only possible upon termination of pregnancy, leading researchers to hypothesize that hormonal changes induced by pregnancy disrupt fatty acid metabolism. This disruption results in accumulation of free fatty acids within hepatocytes and other vital organs—including the kidneys, pancreas, and brain—ultimately causing multiorgan dysfunction.
In its early stages, AFLP typically presents with persistent nausea, vomiting, fatigue, upper abdominal pain, and headache. Jaundice progresses progressively over several days to one week; abdominal pain—predominantly in the right upper quadrant—may also occur. Some patients develop hypertension, proteinuria, and edema. If left untreated, coagulopathy may ensue, manifesting as petechiae, ecchymoses, and gastrointestinal bleeding. In severe cases, hepatic encephalopathy, liver failure, and renal failure may rapidly develop, often culminating in death within a short timeframe. We hope this information proves helpful!
