Symptoms and diagnosis for acute fatty liver of pregnancy

Symptoms of acute fatty liver of pregnancy

Acute fatty liver of pregnancy damages your liver. If you have any of the symptoms below go to A&E:

• Your skin or eyes get a yellow colour (jaundice)
• Confusion, forgetfulness, acting out of character or similar changes – these are caused by hepatic encephalopathy (HE) which is when liver damage affects your brain

Women can have symptoms of acute fatty liver of pregnancy for a few weeks before they become very ill. It is often hard to spot because they are caused by lots of other things – including pregnancy. The most common symptoms include:

• Feeling or being sick
• Tummy pain
• Peeing a lot
• Feeling very thirsty
• Feeling very tired (fatigue)
• Itching

Try not to worry too much if you notice any of these things. Acute fatty liver of pregnancy is very rare so you are unlikely to have it. Tell your midwife or doctor about any symptoms that are worrying or bothering you, or if things just don’t feel right. They can find out what’s happening and get you any treatment you need.

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Tests for acute fatty liver of pregnancy

If you could have acute fatty liver of pregnancy, doctors will diagnose you as quickly as possible.

You will have an ultrasound scan to look at your liver. This can show doctors whether there is a high amount of fat in your liver.

You will have blood tests for viral hepatitis. This is also a cause of sudden liver failure, so doctors need to rule it in or out as soon as possible.

You will also have blood tests to check for signs of liver damage, including:

• Bilirubin
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
• Creatine
• Ammonia
• Urea
• Glucose
• Blood count
• Blood clotting time

You can find out more about these different tests on the NHS website. Most women do not need to have a liver biopsy. Doctors only do this if there isn’t another way to be sure whether you have acute fatty liver of pregnancy.

The doctors will look at your symptoms and test results and compare them to a list called the Swansea Criteria. If you have 6 or more that match, it’s likely that you have acute fatty liver of pregnancy.

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Next

Treatment

Everyone’s experience of acute fatty liver of pregnancy will be different. Always talk to your specialist medical team for personal advice.

Our information aims to be clear, up-to-date, and useful. We work with people living with liver disease and clinicians to make our information.

• How we make our information 

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If you have any feedback or would like a full list of references, you can also let us know by emailing patient-info@britishlivertrust.org.uk.

Clinical reviewer: Professor John Dillon, Professor of hepatology and gastroenterology, School of medicine, University of Dundee

Publication date: December 2025

Next review: December 2028