CASE HISTORY – February 2015

Case report: acute fatty liver during pregnancy

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Abstract

Acute fatty liver during pregnancy (AFLP) is a rare life-threatening condition that occurs in the second half of pregnancy or in the early postpartum period (1). The diagnosis of the condition is difficult to make due to unspecific symptoms which resemble those of other common conditions, e.g. acute hepatitis, preeclampsia and cholestasis during pregnancy (2). The estimated prevalence of AFLP is 1:7000–1:16000 (1).

A pregnant woman at gestational age 33+3 was admitted to East-Tallinn Central Hospital due to jaundice, nausea, vomiting and fatigue during the past week. During the last days she had also felt less fetal movements. A cardiotocogram was performed and there was suspicion that mother´s pulse had been registered. An ultrasound of the fetus was immediately performed and bradycardic heart rate and ineffective systole were detected. An emergency Caesarean section was done immediately. Findings during the operation and laboratory results suggested that the reason for the patient`s condition was AFLP. Laboratory results during hospital stay and follow-up are presented in Table 2. No permanent liver damage was diagnosed at the follow-up visit, and genetic changes associated with AFLP were also ruled out.