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.
The estimated incidence is at around 1 : 7000 - 20000 births.
Patients may present with nausea, vomiting, right upper quadrant pain and / or jaundice.
The pathogenesis may be related to an abnormality in fetal fatty acid metabolism
Imaging features are often that of fatty infiltration of the liver.
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.
May show evidence of low attenuation 3-4 which is again non specific.
Fat accumulation, along with ammonia production by hepatocytes can lead to
- coaguloapthy (e.g. disseminated intravascular coagulation (DIC))
- hypoglycemia secondary to evolving hepatic failure
First described by H L Sheehan et.al in 1940 6
- 1. Ong EM, Drukteinis JS, Peters HE et-al. Multimodality imaging of hepato-biliary disorders in pregnancy: a pictorial essay. Emerg Radiol. 2009;16 (5): 357-63. doi:10.1007/s10140-009-0800-3 - Pubmed citation
- 2. Van le L, Podrasky A. Computed tomographic and ultrasonographic findings in women with acute fatty liver of pregnancy. J Reprod Med. 1990;35 (8): 815-7. - Pubmed citation
- 3. Coche G, Moran V, Boillot A et-al. Acute fatty liver of pregnancy: CT evaluation. Case report. Eur J Radiol. 1988;8 (2): 115-7. - Pubmed citation
- 4. Mabie WC, Dacus JV, Sibai BM et-al. Computed tomography in acute fatty liver of pregnancy. Am. J. Obstet. Gynecol. 1988;158 (1): 142-5. - Pubmed citation
- 5. Monga M, Katz AR. Acute fatty liver in the second trimester. Obstet Gynecol. 1999;93 (5 Pt 2): 811-3. - Pubmed citation
- 6. Sheehan HL (1940). "The pathology of acute yellow atrophy and delayed chloroform poisoning". J Obstet Gynaecol Br. Emp. 47: 49–62.
- 7. Usta IM, Barton JR, Amon EA et-al. Acute fatty liver of pregnancy: an experience in the diagnosis and management of fourteen cases. Am. J. Obstet. Gynecol. 1994;171 (5): 1342-7. - Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Acute fatty liver of pregnancy (AFLP)||✗|
|Hepatic lipidosis of pregnancy||✗|
|Acute fatty liver in pregnancy||✗|