Acute fatty liver of pregnancy, a diagnostic challenge

Vega J.L.M.; Zumaeta E.L.; Yarango M.A.E. · Revista Peruana de Ginecologia y Obstetricia (2024) · DOI: 10.31403/rpgo.v70i2697

Resumen

Acute fatty liver disease of pregnancy is a rare disease that usually presents in the third trimester of gestation, the pathogenesis of which is still unknown. The diagnosis is clinical and is made using the Swansea criteria. This condition causes liver and renal dysfunction, with a maternal mortality rate of 10% and perinatal mortality up to 20%. Initial management consists of termination of pregnancy and maternal hemodynamic support. We present the case of a 32-year-old woman at 38 weeks of gestation who presented with jaundice, abdominal pain and vomiting on the first postpartum day. Laboratory tests revealed alterations in the hepatic and renal profile, coagulopathy and hypoglycemia. Treatment consisted of correction of the metabolic alterations, which improved the laboratory parameters and led to complete recovery of the patient.