Idiopathic fatty liver of pregnancy: findings in ten cases

Ten cases of fatty liver of pregnancy are reported from a large metropolitan medical center for the period 1972 to 1982. Compared to earlier reports, a marked decrease in both maternal and fetal mortality was noted (1 mother died and 2 of 12 infants were stillborn). Eight other cases obtained from liver biopsies referred from other hospitals were also reviewed and combined mortality data were similar. Since delivery was spontaneous in 8 of our 10 patients, the lower mortality cannot be attributed to early delivery. Instead, we ascribe it to improved supportive therapy with transfusions, clotting factors, antibiotics, glucose and monitoring. Also, earlier reports emphasized autopsy material. The incidence of FLP was 1 per 13,328 deliveries in a predominantly Hispanic population. Our review yielded new data concerning presenting signs and symptoms, laboratory features including serial clotting screens documenting disseminated intravascular coagulation (DIC), obstetric and perinatal information as well as maternal follow-up.