An acute fatty liver of pregnancy (AFLP) is a rare and very serious complication in pregnancy affecting about 1 in 7,270 to 13,000 deliveries in the US, more likely women with twins and those with a first pregnancy. AFLP is a form of liver failure due to infiltration of fatty acids causes acute liver insufficiency. AFLP can result in high maternal and neonatal morbidity and mortality, especially if not diagnosed and treated promptly. Some patients who survive AFLP may require liver transplants. Newborns of mothers with AFLP are also at increasec risk of complications.

AFLP can affect any woman of child-bearing age, but occasionally it's associated with preeclampsia.

Pregnant women with AFLP can present with atypical symptoms  of just feeling tired, nausea, vomiting and general malaise. Other symptoms include:

  • Right upper-quadrant and epigastric pain (50-80%)[9]
  • Upper gastrointestinal hemorrhage
  • Acute renal failure
  • Infection
  • Pancreatitis
  • Hypoglycemia
  • Fulminant liver failure with hepatic encephalopathy

Blood tests showing severely abnormal liver enzymes help making the diagnosis.

The same symptoms of acute fatty liver of pregnancy can also be caused by:

  • Drug-Induced Hepatotoxicity
  • Eclampsia
  • HELLP Syndrome
  • Hepatitis, Viral
  • Preeclampsia
  • Toxicity, Acetaminophen

Once AFLP is diagnosed patients should be treated expeditiously which usually includes delivery.