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Acute fatty liver of pregnancy

Dr Abhilash Sandhyala and Dr Yuranga Weerakkody et al.

Acute fatty liver of pregnancy (AFLP) is a rare pregnancy associated condition which tends to manifest in the 3rd trimester of pregnancy / early post partum period.

Epidemiology

The estimated incidence is at around 1 : 7000 - 20000 births. 

Clinical presentation

Patients may present with nausea, vomiting, right upper quadrant pain and  / or jaundice.

Pathology

The pathogenesis may be related to an abnormality in fetal fatty acid metabolism

Associations

Radiographic features

Imaging features are often that of fatty infiltration of the liver.

Ultrasound

Non specific and can even be normal in echotexture 2. However in the context of biliary type symptoms ultrasound may be useful to rule out other overt causes of obstructive biliary tract pathology.

CT

May show evidence of low attenuation 3-4 which is again non specific.

Complications

Fat accumulation, along with ammonia production by hepatocytes can lead to

Etymology

First described by H L Sheehan et.al in 1940 6  

Differential diagnosis

Considerations include
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