Acute Fatty Liver of Pregnancy and Its Clinical Manifestations

Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening obstetric complication that typically occurs in the late stages of pregnancy. It is characterized by jaundice, coagulopathy, hepatic encephalopathy, and liver failure, posing serious risks to both maternal and fetal health. The condition often begins abruptly and can rapidly progress within days or even hours.

In the early phase, most affected women experience nonspecific symptoms such as nausea, vomiting, upper abdominal pain, excessive thirst, and loss of appetite. As the disease progresses, severe jaundice develops, and the condition may escalate rapidly within one to two weeks. Due to impaired blood clotting, patients may exhibit skin bruising and gastrointestinal bleeding, which can quickly lead to multi-organ dysfunction including kidney and liver failure, as well as hepatic encephalopathy. These complications can result in maternal coma, shock, and adverse fetal outcomes such as preterm birth or stillbirth.

AFLP has a high mortality rate, though it is a rare condition, with most cases occurring in the third trimester. The exact cause of AFLP remains unclear, but certain risk factors have been identified, including multiple pregnancies, weight loss, poor nutrition lacking in methionine, viral infections during pregnancy, and the use of tetracycline antibiotics.

Timely delivery is crucial for improving maternal and fetal outcomes. Once diagnosed, immediate termination of pregnancy should be considered regardless of fetal maturity or viability. In addition to delivery, supportive care is essential to stabilize the patient's internal environment and manage complications.

Recognizing early symptoms and prompt medical intervention can significantly increase survival chances for both mother and baby. Awareness among healthcare providers and timely diagnosis play a vital role in managing this critical condition effectively.