Acute Fatty Liver of Pregnancy: A Case Report

Abstract

Diagnosing the aetiology of jaundice is extremely important in pregnant patients as certain conditions like Acute fatty liver of pregnancy (AFLP), HELLP syndrome and intra-hepatic cholestasis of pregnancy (ICP) may require early termination of pregnancy even in the presence of jaundice and or coagulation failure. Once diagnosed, prompt delivery is associated with a significantly improved outcome. A 20 years old primigravida patient with 34 weeks pregnancy presented to outpatient department of obstetrics and gynecology department of SBH Government Medical College, Dhule, with nausea, vomiting, jaundice, ascites and coagulopathy. The patient was subjected to detailed work-up including laboratory investigations and radiological examinations. A diagnosis of acute fatty liver of pregnancy was made based on the Swansea criteria. The labour was induced with delivery of live male fetus of 2.1 kg in good condition. The case of AFLP was managed using supportive treatment in intensive care unit with blood products, careful fluid management and prevention of hypoglycaemia. Careful history and physical examination in conjunction with compatible laboratory and imaging results are often sufficient to make the diagnosis and liver biopsy is rarely indicated.