Acute fatty liver of pregnancy (AFLP) is a serious disorder where fat builds up in the liver of pregnant women. AFLP is likely caused by dysfunction in the mitochondria, which are parts of cells that are involved in energy production. This leads to problems in the processing of fatty acids, causing accumulation of fatty acids in the liver. A mutation or lack of the normal long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) enzyme may cause this dysfunction.
AFLP usually occurs in the third trimester of pregnancy or soon after birth. Women who are experiencing their first pregnancy, are expecting more than one baby in a pregnancy, have pre-eclampsia, or are carrying a male fetus have a greater risk of AFLP. Symptoms of AFLP are nausea, vomiting, pancreatitis, general discomfort, high blood pressure, elevated heart rate, bleeding, upper abdominal pain, kidney failure, jaundice, hypoglycemia, low urine output, and sudden liver failure. AFLP can be diagnosed using a physical exam and imaging techniques such as ultrasound.
Treatment for AFLP is delivery of the fetus. Before and after the delivery, the mother should be monitored for hypoglycemia and bleeding and the baby should be screened for abnormalities in fatty acid metabolism. If you have been diagnosed with acute fatty liver of pregnancy, talk to your doctor or obstetrician immediately as this is a very serious pregnancy complication. In addition, a genetic counselor can help discuss inheritance and risks to other family members. Support groups are available for more resources and information.