What is acute fatty liver of pregnancy (AFLP)?

AFLP is a rare, but serious, liver problem in pregnancy. With AFLP the liver cells have too much fat, which can damage the liver. 

What causes acute fatty liver of pregnancy?

Healthcare providers don’t know the exact cause of AFLP. Fats called triglycerides and fatty acids are normally broken down in the liver. But with AFLP your body makes too much of these. Research shows that AFLP may be an inherited problem with how the liver breaks down fats.

Who is at risk for acute fatty liver of pregnancy?

AFLP is rare, but it is more likely if you are: 

• Having your first pregnancy

• Pregnant with twins or more

• Pregnant with a boy 

• Thin 

There is a chance that AFLP can happen again with a future pregnancy.

What are the symptoms of acute fatty liver of pregnancy?

AFLP usually starts late in the third trimester of pregnancy. These are the most common symptoms of AFLP:

• Nausea and vomiting

• Belly pain, especially in the top right side

• Feeling unwell (malaise)

• Headache

• Tiredness

• Confusion

• Yellowing of skin, eyes, and mucous membranes (jaundice)

The symptoms of AFLP may look like other health conditions. Always see your healthcare provider for a diagnosis.

How is acute fatty liver of pregnancy diagnosed?

To diagnose AFLP, your healthcare provider will review your health history and do a physical exam. The best way to diagnose AFLP is by a liver biopsy. This involves taking a sample of liver tissue for exam under a microscope. It may not always be possible in pregnancy. Most often, your symptoms of AFLP are enough to diagnose the condition. Blood tests can check for other conditions that have similar symptoms. Other tests that may be used include:

• Ultrasound. This test uses sound waves and a computer to make images of blood vessels, tissues, and organs.

• CT scan. This test uses a combination of X-rays and a computer to make detailed images of the body.

How is acute fatty liver of pregnancy treated?

Once AFLP is diagnosed, your baby is delivered as quickly as possible. This can help lower the risks to you and your baby. You may need to be in intensive care for several days after delivery. In most cases, your liver function returns to normal within a few weeks.

What are possible complications of acute fatty liver of pregnancy?

Both you and your developing baby can become very sick if AFLP is not treated. You can have liver failure, severe bleeding, kidney failure, and severe infection. These can be life-threatening for both you and your baby. Getting an early diagnosis and treatment is important.

What can I do to prevent acute fatty liver of pregnancy?

AFLP is a serious condition that can’t be predicted or prevented.

Key points about acute fatty liver of pregnancy

• AFLP is a rare but serious liver problem in which there is too much fat in the liver or liver cells.

• Healthcare providers don’t know the exact cause of AFLP.

• AFLP is more common in first pregnancies.

• A liver biopsy is the best way to diagnose AFLP.

• Once the condition is diagnosed, the baby is delivered as quickly as possible to lower the risks to mother and baby.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.