Acute Fatty Liver of Pregnancy

Some women develop a type of fatty liver in the final trimester (last three months) of their pregnancy; this is known as acute fatty liver of pregnancy (AFLP).

AFLP is a very rare condition.  It occurs in about 1 in 20,000 pregnancies and is more common in first pregnancies, male babies and twins.

It is not known what causes this pregnancy specific liver condition but some feel it is a variant of pre-eclampsia (raised blood pressure and protein in the urine caused by pregnancy). It has also been linked to an inherited enzyme deficiency called long chain acyl-CoA dehydrogenase (LCHAD) in the baby.

LCHAD deficiency is a rare autosomal recessive disorder. This means a gene must be inherited from both parents for an individual to be affected.  Often men and women do not know they are a carrier of this changed (mutated) gene, as their bodies are able to continue to metabolise fatty acids normally.  However, when both mother and father carry the gene and both genes are passed on to the baby, the baby is then unable to metabolise some fatty acids and a build-up can occur in the womb. 

The un-metabolised free fatty acids return from the baby, via the placenta, to the mother’s blood stream. This can result in hepatic stress for the mother, causing fat infiltrations to build up in the liver (fatty liver disease).

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What are the symptoms OF AFLP?

Often symptoms of AFLP are non-specific and can be mistaken for another condition, making early diagnosis difficult.  Symptoms of AFLP may include:

• nausea and vomiting
• lack of appetite
• abdominal pain and indigestion
• non-specifically feeling unwell (malaise)
• excessive tiredness (fatigue)
• jaundice – a condition in which the whites of the eyes go yellow and, in more severe cases, the skin also turns yellow (for more information see useful words)
• excessive thirst

If your symptoms are severe or begin to get worse, you should go straight to hospital.

Acute fatty liver of pregnancy is a very serious condition that can cause rapid liver and kidney failure and can be life-threatening for both mother and baby if not diagnosed.

For more information, download the guide below.

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Download:  Acute Fatty Liver of Pregnancy AFLP/01/12

To view the references for this information and publication please click here

Reviewed by: Professor Chris Day MA PhD MD FRCP Professor of Liver Medicine, Centre for Liver Research, University of Newcastle-upon-Tyne; Dr Marian Knight, Senior Clinical Research Fellow/Honorary Consultant in Public Health, National Perinatal Epidemiology Unit, University of Oxford; Dr Leonie Penna, Consultant in Obstetrics and Foetal Medicine, King’s College Hospital; Professor Catherine Nelson-Piercy MA FRCP FRCOG, Professor of Obstetric Medicine, Consultant Obstetric Physician, Guy’s & St Thomas’ Foundation Trust

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