Acute Fatty Liver of Pregnancy Etiology

and fats—are used in anabolic reactions to synthesize necessary materials for the body’s cells and tissues (Table 1). Fats are categorized as saturated, monounsaturated, and polyunsaturated and are broken down further into short-, medium-, and longchain fats; the length is determined by the number of carbons attached to the molecule. Metabolism of fatty acids is a complex process requiring bile acids, lipase, and several essential enzymes. The enzyme that is deficient in AFLP is long-chain 3hydroxyacyl-coenzyme A dehydrogenase (LCHAD). Approximately 19% to 25% of women in whom AFLP develops are carrying a fetus with LCHAD deficiency. LCHAD deficiency is an autosomal recessive disorder of mitochondrial fatty acid β-oxidation. A woman heterozygous for LCHAD deficiency may be unaware she has a mutation associated with the deficiency and may be asymptomatic until late in pregnancy when AFLP Holly Castello, RN, MSN, CCRN Lisa Schoch, RN, MSN, CCRN Tracy A. Grogan, RN, BSN, MEd, CCRN Acute Liver Failure in an Obstetric Patient: Challenge of Critical Care for 1 Patient With 2 Subspecialty Needs