User:Mr. Ibrahem/Acute fatty liver of pregnancy

Acute fatty liver of pregnancy (AFLP) is a complication of pregnancy that results in liver failure. Early symptoms may include nausea, loss of appetite, abdominal pain, and high blood pressure. Later symptoms may include yellow skin, bleeding problems, and confusion. Onset is in the third trimester or shortly after delivery.

Risk factors include certain genetic mutations, preeclampsia, a male baby or more than one baby, obesity, diabetes, and previously being affected. The underlying mechanism is not entirely clear but may involve long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency or carnitine palmitoyltransferase I deficiency which leads to fat build up in the liver. Diagnosis can generally be made based on symptoms and blood tests, without the need for a liver biopsy.

Treatment involves supportive care and delivery of the baby. Correction of low blood sugar and electrolyte problems may be required. Delivery may occur by induction or C-section. Rarely liver transplantation is required. With early and rapid treatment, the risk of death for the mother is about 4% and that for the baby is about 15%. Problems generally begin resolving a few days after delivery.

Acute fatty liver of pregnancy occurs in about 1 in 12,500 pregnancies. Rates appear to be similar in different cultures. It was mentioned in an obstetrics textbook by John Whitridge Williams in 1903 and described in a case report in 1934. Recognition as a separate disease occurred in 1940 when Harold Leeming Sheehan referred to as “acute yellow atrophy of the liver”.