Acute Fatty Liver of PregnancyA Case Series from a Tertiary Hospital of Kolkata, India: A Case Series

Abstract

Acute Fatty Liver of Pregnancy (AFLP) is a rare, life-threatening complication of pregnancy that affects women in the third trimester or immediate postpartum period. Although the exact pathogenesis is poorly understood, it has been linked to a deficiency in Long Chain 3-hydroxyacyl-CoA Dehydrogenase (LCHAD) in foetal fatty acid metabolism. The early diagnosis of AFLP can sometimes be challenging due to overlapping features with severe preeclampsia, Haemolysis Elevated Liver Enzymes, Low Platelet (HELLP) syndrome, viral hepatitis, and cholestasis of pregnancy. It is a diagnosis of exclusion when no other known liver diseases are present in the mother. Herein, the authors presented a case series of four cases of AFLP, including their chief complaints, clinicopathological findings, management, and outcomes. Early diagnosis, termination of pregnancy, and multidisciplinary management in the postdelivery period are crucial for improving foetomaternal prognosis.

Keywords

• disseminated intravascular coagulopathy
• elevated liver enzymes
• low platelets (hellp)
• long chain 3-hydroxyacyl-coa dehydrogenase
• multiple organ dysfunction