A Case Of Fulminant Acute Fatty Liver Of  Pregnancy

Dr. Shreya P. Butala; Dr. Naim M. Kadri; Dr. Khushali Kotecha

Volume : VI, Issue : X, October - 2016

A Case Of Fulminant Acute Fatty Liver Of Pregnancy

Dr. Shreya P. Butala, Dr. Naim M. Kadri, Dr. Khushali Kotecha

Abstract :

Acute fatty liver of pregnancy(AFLP) is a serious complication of late third trimester of pregnancy, characterized by microvesicular steatosis of liver leading to acute liver insufficiency. It is more common in nulliparous with a male fetus. It generally occurs in women heterozygous for Long–Chain 3–hydroxy acyl–coenzyme A dehydrogenase (LCHAD), which is necessary for of fatty acid oxidation. Patients generally presents with non specific complaints of malaise, nausea, vomiting, right hypochondriac pain, jaundice. In severe cases, multisystem involvement including acute renal failure, encephalopathy, gastrointestinal bleeding, pancreatitis, coagulopathy, hypoglycemia occurs. The most striking feature is high level of bilirubin associated with moderate increase of transaminases. Early diagnosis, prompt delivery and intensive supportive care are the cornerstones in the management of AFLP. Maternal mortality rates in the past were 75% but with prompt diagnosis and timely treatment mortality rate has decreased to approximately 18%. Neonatal mortality rates are usually higher (60 to 85%).