In plain words
Acute fatty liver of pregnancy is a rare, serious condition of the liver. Fat builds up in liver cells, and the liver begins to fail. It usually appears in the third trimester, often near the due date. Early signs can look like heartburn, nausea, or extreme tiredness. Clinicians check blood tests and liver function. The condition is treated in a hospital, and it often means the baby is delivered. Because it is rare, many mothers and some clinicians do not think of it first. Call your provider the same day if heartburn or nausea is new or persistent, or comes with yellow eyes, belly pain, or unusual bruising. Those signs need a check now.
The deeper version
Acute fatty liver of pregnancy (AFLP) is a microvesicular steatosis of hepatocytes, usually presenting in the third trimester, with an incidence reported at roughly 1 in 10,000 to 15,000 births in Western series. It is linked to defects in mitochondrial fatty acid beta-oxidation, most often long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency in the fetus. Diagnosis rests on clinical features, hypoglycemia, elevated transaminases, coagulopathy, and renal impairment, and it overlaps with syndrome and . Management is prompt delivery after stabilization. The controversy concerns how far maternal genetic screening should be used and whether earlier recognition would change outcomes. Recurrence risk in later pregnancies is considered modest but present.
Where it comes up
- Itching that won't stop: cholestasisPregnancy: Your Body
- Heartburn and refluxPregnancy: Your Body
- Going past your due datePregnancy: Your Body
What mothers here say about acute fatty liver of pregnancy
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Sources
- Knight M and colleagues, BJOG — Acute fatty liver of pregnancy: incidence, outcomes and associations in a UK national cohort (2008)
- American College of Obstetricians and Gynecologists — Practice Bulletin 222: Gestational Hypertension and Preeclampsia (2020), for the HELLP and liver-involvement differential