Acute Fatty Liver of Pregnancy - A Rare but Fatal Obstetric Complication

Ritambhara Ratnapriya, Ratna Biswas, Nikita Saxsena

Abstract: Acute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post - partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention. Case Summary: A 39 yr old primigravida, IVF conceived at 29 wks period of gestation was referred from Indira IVF center ivojaundice. She had yellowish discolouration of eyes and urine since 3 days. Her AST/ALT was 2911/1889. There was no history of fever, vomiting and diarrhoea. Due to deteriorating maternal condition, her EmLSCS was done. Intra - op her liver was shrunken. Liver biopsy was taken which was suggestive of acute fatty liver. In post op period, pt was in ICU for 8 days, but she recovered. Conclusion: There should be a high index of suspicion of this condition in women presenting with jaundice in pregnancy. Delay in diagnosis is associated with increased maternal morbidity and mortality.

Keywords: Acute fatty liver of pregnancy, Jaundice