Maternal and neonatal outcomes in acute fatty liver of pregnancy: A rare obstetric emergency

Acute fatty liver of pregnancy (AFLP) is a rare, life-threatening obstetric emergency, usually occurring in the third trimester, with an incidence of 1 in 5,000–20,000 pregnancies. Early diagnosis is challenging due to overlap with preeclampsia, HELLP syndrome, and viral hepatitis. AFLP results from fetal long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, leading to maternal hepatic injury. Diagnosis is based on Swansea criteria. Prompt delivery and intensive supportive care are essential to reduce maternal and neonatal mortality. A retrospective study was done in our hospital over a period of 15 years, out of which we report 12 cases of AFLP of varied maternal and neonatal outcomes. We analysed patient’s data for 5 cases among them with different maternal and neonatal outcomes for demographic background, presenting complaints, obstetric parameters, laboratory work up, mode of delivery, disease severity, ICU interventions, and rate of serious morbid complications. Patients with AFLP have significant perioperative mortality and morbidity. Clinical outcome can be improved by prompt diagnosis, early delivery of foetus and supportive care from multidisciplinary team.