Acute fatty liver during pregnancy and gestational diabetes insipidus: a case report

Abstract

Acute fatty liver during pregnancy (AFLP) is an emergency and potentially fatal condition occurring during the peripartum period. It is characterized by fatty microvascular infiltration of hepatocytes and has an incidence rate of approximately one in 7,000 to one in 20,000 pregnancies. It may induce profound liver failure and can be accompanied by renal failure, polydipsia/polyuria, disseminated intravascular coagulation, hypoglycemia, and encephalopathy. Emergency delivery at the appropriate time is crucial to control the development of AFLP. Gestational diabetes insipidus (GDI) is another rare disorder characterized by polyuria, polydipsia, and dehydration. It has an incidence rate of 2-4 cases/100,000 pregnancies and develops during the third trimester. Here the authors present the case of a patient with AFLP and transient GDI complicated with non-reassuring fetal status. The conditions were resolved after delivery and multidisciplinary intensive care.

Keywords

• acute fatty liver during pregnancy
• deamino arginine vasopressin
• fetal distress
• gestational diabetes insipidus
• pregnancy complications