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Potentially life-threatening emergency
Acute fatty liver of pregnancy
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Potentially life-threatening emergency

Acute fatty liver of pregnancy

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Contributors: Mitchell Linder MD
Other Resources UpToDate PubMed

Synopsis

Acute fatty liver of pregnancy is a rare, potentially life-threatening condition with maternal and fetal mortality rates each approaching about 20%. Incidence is 1 in 10 000-15 000 pregnancies. Etiology is unknown but thought to be related to issues with fetal fatty acid metabolism. Risk factors include carrying a male fetus, history of preeclampsia, and having multiples.

Patients can present in numerous ways but will usually be in the third trimester and have nausea, vomiting, headache, and abdominal pain. The patient likely will be jaundiced. Other symptoms can include fever, decreased urine output or anuria, hypoglycemia, and tachycardia. Cases often rapidly progress to multisystem organ failure including renal failure, gastrointestinal tract bleeding, disseminated intravascular coagulation (DIC), encephalopathy, and pancreatitis.

Fetal mortality is related to metabolic acidosis as a byproduct of maternal metabolic acidosis.  

This can recur in subsequent pregnancies.

Codes

ICD10CM:
O26.619 – Liver and biliary tract disorders in pregnancy, unspecified trimester

SNOMEDCT:
716379000 – Acute fatty liver of pregnancy

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Last Reviewed: 04/04/2018
Last Updated: 04/13/2018
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Potentially life-threatening emergency
Acute fatty liver of pregnancy
Print 1 Images
Acute fatty liver of pregnancy : Jaundice, Nausea, Vomiting, ALT elevated, Hypoglycemia, Leukocytosis, Malaise, Hyperbilirubinemia, Serum ammonia increased
Copyright © 2019 VisualDx®. All rights reserved.