Maternal and Perinatal Outcomes in Acute Fatty Liver of Pregnancy

Background: Acute Fatty Liver of Pregnancy (AFLP) is a rare obstetric condition that can lead to maternal and perinatal complications. Aim and Objectives: This study aimed to study the pregnancy outcome in Acute fatty liver of Pregnancy (AFLP). In particular, this study aimed to study the clinical features of the condition and its effect on maternal and perinatal outcomes. Materials and Methods: A retrospective analysis of seven cases diagnosed with AFLP over a span of three years was performed. The clinical records of these women were reviewed for clinical features, laboratory investigations, and maternal and perinatal outcomes. Results: The incidence of AFLP was 4/10,000 births. A total of 6(85.7%) women presented during the third trimester of pregnancy. A total of 4(57%) of them presented after 36 weeks of gestation. A total of 6(85.7%) women presented with jaundice, and all presented with sudden onset nonspecific symptoms, including abdominal pain and vomiting. Pregnancy was terminated by cesarean section in 6 cases. Maternal mortality was noted in 6(85.7%) of women. All six women were diagnosed with Acute kidney injury and coagulopathy. One woman had developed encephalopathy and altered sensorium. Further, 2(28.5%) women had intrauterine fetal demise at the time of presentation, and 1(14.3%) had an early neonatal death. Conclusion: AFLP is a rare clinical syndrome with rapid and dramatic progression, beginning initially with non-specific symptoms and evolving into coagulopathy, acute kidney injury, and death, resulting in alarming maternal and perinatal mortality. Early diagnosis is challenging due to the non-specificity of symptoms, but crucial and prompt termination of pregnancy is the need of the hour. Nonetheless, supportive treatment and a multidisciplinary approach may significantly improve prognosis.