[Acute fatty liver in pregnancy]

Area of Science:

• Obstetrics and Gynecology
• Hepatology
• Critical Care Medicine

Background:

• Acute fatty liver in pregnancy (AFLP) is a rare, life-threatening condition affecting pregnant individuals in the third trimester.
• Characterized by rapid onset of jaundice, liver failure, and encephalopathy, AFLP presents significant risks to both mother and fetus.
• The etiology of AFLP remains largely unknown, necessitating detailed case reports for better understanding.

Observation:

• A patient at 36 weeks gestation presented with jaundice and bleeding, complications indicative of AFLP.
• Following the delivery of a deceased infant, the patient experienced rapid deterioration, including worsening jaundice, severe hemorrhage, and encephalopathy.
• Liver echogenicity was increased, consistent with a diagnosis of AFLP.

Findings:

• Despite severe hemorrhage, encephalopathy, acute renal failure, polyserositis, and adult respiratory distress syndrome, the patient achieved a successful recovery.
• Maximal supportive therapy and spontaneous delivery were key interventions in the patient's management.
• This case demonstrates that recovery is possible even in the presence of multiple organ system failures.

Implications:

• This case underscores the importance of prompt diagnosis and aggressive supportive management in cases of acute fatty liver in pregnancy.
• Successful recovery highlights the potential for positive outcomes with intensive care, even in critically ill patients.
• Further research into AFLP's pathophysiology is crucial for developing targeted treatments and improving maternal and fetal survival rates.