Patient education: Acute fatty liver of pregnancy (The Basics)

What is acute fatty liver of pregnancy? — 

Acute fatty liver of pregnancy, or "AFLP," is a rare but serious liver problem that can happen during pregnancy.

It is not clear exactly what causes AFLP. But the risk seems to be higher in people who:

●Had AFLP before

●Are pregnant with more than 1 baby (such as twins)

●Have other problems related to pregnancy, like preeclampsia

●Are pregnant with a male fetus

●Are underweight

●Have not been pregnant before

When AFLP happens, it is usually later in pregnancy, between about 30 and 38 weeks. But it can sometimes happen earlier or later.

AFLP can be serious because it can cause the fetus (developing baby) to not get enough oxygen.

What are the symptoms of AFLP? — 

At first, the symptoms can include:

●Nausea

●Vomiting

●Belly pain

●Feeling very tired

●Headache

●Loss of appetite

If the liver stops working, it can cause more serious problems such as:

●Jaundice (when the skin and whites of the eyes turn yellow)

●Fluid buildup in the belly

●Confusion

●Low blood sugar

●Problems with blood clotting

●Damage to the kidneys and other organs

Will I need tests? — 

Yes. If your doctor or nurse suspects AFLP, they will do an exam and ask about your symptoms.

They will also order blood tests, including tests to check how your liver is working. They might do imaging tests, such as ultrasound, to look at your liver. This can help them figure out if your symptoms are caused by AFLP or another problem.

How is AFLP treated? — 

The main treatment for AFLP is to give birth, even if it means your baby will be born early. The exact timing, and how you will give birth, depends on your and your baby's health.

When it is time to give birth:

●You might get medicine to start contractions. This is called "inducing labor." It might be an option if your liver problems are not getting worse quickly and your doctor thinks you can have a vaginal birth.

●If there is concern about your or your baby's health getting worse quickly, you might need to have a cesarean birth ("c-section"). This is surgery to get the baby out of the uterus.

If your baby needs to be born early ("preterm"), they will get special care in the hospital.

After giving birth, most people recover and their liver starts working normally again. But your doctor will do regular tests and monitoring in the hospital.

Some people need care in the intensive care unit, or "ICU." This involves close monitoring, and getting fluids and medicines through a thin tube that goes into a vein, called an "IV." It might also involve breathing help, nutrition, and treatment for other health problems. In severe cases, you might need a liver transplant.

Can AFLP be prevented? — 

No. But if you had AFLP in the past, your chances of getting it again are higher. If you get pregnant again, you will get special care during pregnancy. This includes regular tests and monitoring for symptoms.

More on this topic

Patient education: Acute liver failure in adults (The Basics)
Patient education: HELLP syndrome (The Basics)
Patient education: Preeclampsia (The Basics)
Patient education: Labor induction (The Basics)
Patient education: Cesarean birth (The Basics)
Patient education: What to expect in the NICU (The Basics)

Patient education: Preeclampsia (Beyond the Basics)
Patient education: C-section (cesarean birth) (Beyond the Basics)