Acute fatty liver of pregnancy, a diagnostic challenge

Abstract

Acute fatty liver disease of pregnancy is a rare disease that usually presents in
the third trimester of gestation, the pathogenesis of which is still unknown. The
diagnosis is clinical and is made using the Swansea criteria. This condition causes
liver and renal dysfunction, with a maternal mortality rate of 10% and perinatal
mortality up to 20%. Initial management consists of termination of pregnancy and
maternal hemodynamic support. We present the case of a 32-year-old woman at 38
weeks of gestation who presented with jaundice, abdominal pain and vomiting on
the first postpartum day. Laboratory tests revealed alterations in the hepatic and
renal profile, coagulopathy and hypoglycemia. Treatment consisted of correction
of the metabolic alterations, which improved the laboratory parameters and led to
complete recovery of the patient.