Analysis of seven consecutive cases of acute fatty liver of pregnancy: single center experience in China

Objectives: To summarize the clinical characteristics, and maternal and neonatal outcomes in patients who were diagnosed with acute fatty liver of pregnancy (AFLP). Methods: A retrospective case series study over 10 years was conducted at the Nantong Third People’s Hospital, Nantong University, China. Seven cases diagnosed as AFLP were included. The medical records were reviewed for clinical presentations, laboratory tests, and maternal and neonatal outcomes. Results: All patients presented with nausea, vomiting, malaise, and abdominal pain at a median of 34 weeks of gestation, then progressive jaundice subsequently. Four cases were diagnosed in the antepartum period, and three cases in early postpartum period. Complications revealed with acute renal failure in 4 patients (57.1%). Hepatic encephalopathy, pancreatitis, sepsis and multiple organ dysfunction syndrome were seen in 2 patients (28.6%). Delivery occurred by caesarean section in 5 patients (71.4%) and vaginally in 2 patients (28.6%). There were two maternal death (28.6%) and one neonatal death (12.5%). Conclusions: AFLP is still a potentially lethal complication of pregnancy. All patients suspected with such diagnosis should undergo screening for the laboratory tests. Early recognition and timely termination of pregnancy are essential to improve pregnancy outcomes.