Advertisement
Research Article| Volume 7, ISSUE 4, P799-808, October 1991

Acute Fatty Liver of Pregnancy

  • William C. Mabie
    Correspondence
    Address reprint requests to: William C. Mabie, MD, 853 Jefferson Avenue, Suite E102, Memphis, TN 38103
    Affiliations
    Associate Professor, Division of Maternal-Fetal Medicine, Departrnent of Obstetrics and Gynecology, University of Tennessee, Memphis, Tennesse
    Search for articles by this author
DOI:https://doi.org/10.1016/S0749-0704(18)30281-1
Acute Fatty Liver of Pregnancy
Previous ArticleCardiac Disease in Pregnancy
Next ArticleClinical Management of Thromboembolic Disorders in Pregnancy
      This paper is only available as a PDF. To read, Please Download here.
      Acute fatty liver of pregnancy (AFLP) is a rare disease of unknown cause with onset in the third trimester. It is characterized by microvesicular fatty infiltration of the liver, coagulopathy, and encephalopathy Renal insufficiency is common. Approximately half of these patients have signs and symptoms of preeclampsia, making the differentiation between the HELLP (H = hemolysis, EL = elevated liver enzymes, and LP = low platelets) syndrome and AFLP difficult. Diagnosis is based primarily on liver biopsy with special stains for fat. Treatment consists of delivery and maximal supportive care.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Critical Care Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Ahola S.J.
        • Lyman B.T.
        • Hogan A.F.
        Acute fatty liver of pregnancy: Increased survival by early recognition and aggressive therapy.
        Diagnostic Gynecology and Obstetrics. 1982; 4: 69
        • Allen E.S.
        • Brown W.E.
        Hepatic toxicity of tetracycline in pregnancy.
        Am J Obstet Gynecol. 1966; 95: 12

      3. Amon E, Allen SR, Petrie RH, et al: Acute fatty liver of pregnancy associated with preeclampsia: Management of hepatic failure with postpartum liver transplantation. Am J Perinatol, in press

        • Baker W.
        • Cefalo R.C.
        Fulminant hepatic failure in the third trimester of pregnancy.
        J Reprod Med. 1985; 30: 229
        • Barron W.M.
        • Cohen L.H.
        • Ulland L.A.
        • et al.
        Transient vasopressin-resistant diabetes insipidus of pregnancy.
        N Engl J Med. 1984; 310: 442
        • Barton J.R.
        • Sibai B.M.
        • Mabie W.C.
        • et al.
        Recurrent acute fatty liver of pregnancy.
        Am J Obstet Gynecol. 1990; 163: 534
        • Bernau J.
        • DeGott C.
        • Nouel O.
        • et al.
        Non-fatal acute fatty liver of pregnancy.
        Gut. 1983; 24: 340
        • Breen K.J.
        • Perkins K.W.
        • Mistilis S.P.
        • et al.
        Idiopathic acute fatty liver of pregnancy.
        Gut. 1970; 11: 822
        • Breen K.J.
        • Perkins K.W.
        • Schenker S.
        • et al.
        Uncomplicated subsequent pregnancy after acute idiopathic fatty liver of pregnancy.
        Obstet Gynecol. 1972; 40: 813
        • Brown M.A.
        • Passaris G.
        • Carlton M.A.
        Pregnancy-induced hypertension and acute fatty liver of pregnancy: Atypical presentations.
        Am J Obstet Gynecol. 1990; 163: 1154
        • Brown M.S.
        • Reddy K.R.
        • Hensley G.T.
        • et al.
        The initial presentation of fatty liver of pregnancy mimicking acute viral hepatitis.
        Am J Gastroenterol. 1987; 82: 554
        • Burroughs A.K.
        • Seong N.H.
        • Dojcinov D.M.
        • et al.
        Idiopathic acute fatty liver of pregnancy in 12 patients.
        Q J Med. 1982; 204: 481
        • Cammu H.
        • Velkeniers B.
        • Charels K.
        • et al.
        Idiopathic acute fatty liver of pregnancy associated with transient diabetes insipidus. Case report.
        Br J Obstet Gynecol. 1987; 94: 173
        • Davies M.H.
        • Wilkinson S.P.
        • Hanid M.A.
        • et al.
        Acute liver disease with encephalopathy and renal failure in late pregnancy and the early puerperium: A study of 14 patients.
        Br J Obstet Gynecol. 1980; 87: 1005
        • De Swiet M.
        Some rare medical complications of pregnancy.
        Br Med J. 1985; 290: 2
        • Ebert E.C.
        • Sun E.A.
        • Wright S.H.
        • et al.
        Does early diagnosis and delivery in acute fatty liver of pregnancy lead to improvement in maternal and infant survival?.
        Dig Dis Sci. 1984; 29: 453
        • Eisele J.W.
        • Barker E.A.
        • Smuckler E.A.
        Lipid content in the liver of fatty metamorphosis of pregnancy.
        Am J Pathol. 1975; 81: 545
        • Goyert G.L.
        • Bottoms S.F.
        • Sokol R.J.
        Anicteric presentation of fatal herpetic hepatitis in pregnancy.
        Obstet Gynecol. 1985; 65: 585
        • Haemmerli U.P.
        Jaundice during pregnancy: With special emphasis on recurrent jaundice during pregnancy and its differential diagnosis.
        Acta Med Scand. 1966; 179 (Suppl 144): 1
        • Hague W.M.
        • Fenton D.W.
        • Duncan S.L.B.
        • et al.
        Acute fatty liver of pregnancy.
        JR Soc Med. 1983; 76: 652
        • Harper M.
        • Hatjis C.G.
        • Appel R.G.
        • et al.
        Vasopressin-resistant diabetes insipidus, liver dysfunction, hyperuricemia, and decreased renal function.
        J Reprod Med. 1987; 32: 862
        • Hou S.H.
        • Levin S.
        • Ahola S.
        • et al.
        Acute fatty liver of pregnancy: Survival with early cesarean section.
        Dig Dis Sci. 1984; 29: 449
        • Kahil M.E.
        • Fred H.L.
        • Brown H.
        • et al.
        Acute fatty liver of pregnancy.
        Arch Intern Med. 1964; 113: 63
        • Kaplan M.M.
        Acute fatty liver of pregnancy.
        N Engl J Med. 1985; 313: 367
        • Lauersen B.
        • Frost B.
        • Mortensen J.Z.
        Acute fatty liver of pregnancy with complicating disseminated intravascular coagulation.
        Acta Obstet Gynecol Scand. 1983; 62: 403
        • Mabie W.C.
        • Dacus J.V.
        • Sibai B.M.
        • et al.
        Computed tomography in acute fatty liver of pregnancy.
        Am J Obstet Gynecol. 1988; 158: 142
        • Minakami H.
        • Oka N.
        • Sato T.
        • et al.
        Preeclampsia: A microvesicular fat disease of the liver?.
        Am J Obstet Gynecol. 1988; 159: 1043
        • Minuk G.Y.
        • Lui R.C.
        • Kelly J.K.
        Rupture of the liver associated with acute fatty liver of pregnancy.
        Am J Gastroenterol. 1987; 82: 457
        • Moise Jr., K.J.
        • Shah D.M.
        Acute fatty liver of pregnancy: Etiology of fetal distress and fetal wastage.
        Obstet Gynecol. 1987; 69: 482
        • Obritsch J.M.
        • Cardwell M.S.
        Acute fatty liver of pregnancy.
        Mo Med. 1990; 87: 149
        • Ockner S.A.
        • Brunt E.M.
        • Cohn S.M.
        • et al.
        Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthotopic liver transplantation.
        Hepatology. 1990; 11: 59
        • Pockros P.J.
        • Peters R.L.
        • Reynolds T.B.
        Idiopathic fatty liver of pregnancy: Findings in 10 cases.
        Medicine (Baltimore). 1984; 63: 1
        • Riely C.A.
        Acute hepatic failure at term.
        Postgrad Med. 1980; 68: 118
        • Riely C.A.
        Acute fatty liver of pregnancy—1984.
        Dig Dis Sci. 1984; 29: 456
        • Riely C.A.
        Acute fatty liver of pregnancy.
        Semin Liver Dis. 1987; 7: 47
        • Riely C.A.
        Case studies in jaundice of pregnancy.
        Semin Liver Dis. 1988; 8: 191
        • Riely C.A.
        • Latham P.S.
        • Romero R.
        • et al.
        Acute fatty liver of pregnancy.
        Ann Intern Med. 1987; 106: 703
        • Rolfes D.B.
        • Ishak K.G.
        Acute fatty liver of pregnancy: A clinicopathologic study of 35 cases.
        Hepatology. 1985; 5: 1149
        • Slater D.N.
        • Hague W.M.
        Renal morphological changes in idiopathic acute fatty liver of pregnancy.
        Histopathology. 1984; 8: 567
        • Synder R.R.
        • Hankins G.D.V.
        Etiology and management of acute fatty liver of pregnancy.
        Clin Perinatol. 1986; 13: 813
        • Weber F.L.
        • Snodgrass P.J.
        • Powell D.E.
        • et al.
        Abnormalities of hepatic mitochondrial ureacycle enzyme activities and hepatic ultrastructure in acute fatty liver of pregnancy.
        J Lab Clin Med. 1979; 94: 27
        • Wilkinson M.L.
        Diagnosis and management of liver disease in pregnancy.
        Adv Intern Med. 1990; 35: 289

      Article info

      Identification

      DOI: https://doi.org/10.1016/S0749-0704(18)30281-1

      Copyright

      © 1991 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX