Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 ...
59
Description

Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 • Defect in fetal free fatty acid metabolism products → Intermediate fatty acid metabolism accumulate → Fat infiltrates maternal hepatocytes → Liver dysfunction
Presentation:
 • Typically 3rd trimester (range: 18 wks - postpartum):
 • Initial symptoms = nonspecific (nausea, vomiting, abdominal pain, headache, malaise)
 → Acute liver failure rapidly develops (DIC, ascites, jaundice, hypoglycemia, encephalopathy)
 → Multiorgan failure
Findings:
 • ↑AST/ALT (5-10x ULN), ↑Tbili/Dbili/AP, ↑INR, ↑BUN/Cr, ↓Glucose, ↓PLT, ↓Fibrinogen, ↓Antithrombin Ill
 • Ultrasound = nonspecific (fatty infiltration, brightness)
 • Biopsy is rarely needed (microvesicular fatty infiltration)
Differential Diagnosis: Viral Hepatitis, Preeclampsia, HELLP, Intrahepatic Cholestasis
Management:
 • Maternal Support - Critical care support, Transfer to a liver transplant center
 • Prompt Delivery - Regardless of gestational age
 • Monitor and Treat Complications

by Dr. Yi Feng @yfeng_MD via @iMedEducation

#AFLP #Fatty #Liver #Pregnancy #hepatology #obstetrics #obgyn #diagnosis #management #pathophysiology 
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
Medical jobs
view all

0 Comments

Related content