Issue: 2002 > October > case report

Acute fatty liver in pregnancy

A. C. I. T. L. Tan, J. H. J. M. van Krieken, W. H. M. Peters, E. A. P. Steegers


When confronted with liver abnormalities during the third trimester of pregnancy, one should consider acute fatty liver of pregnancy. The differential diagnosis with (pre-)eclampsia and HELLP syndrome is sometimes difficult. In these cases a liver biopsy is helpful though rarely performed during preg-nancy. After delivery of the child the liver test abnormalities will ultimately disappear. Recent publications reveal that a dysfunction in the b-oxidation of mitochondrial fatty acids may contribute to the aetiology of this rare disorder. We describe a case of acute fatty liver in pregnancy, with liver dysfunction (decreased albumin, prolonged prothrombin time) slowly returning to normal after delivery. Testing for disorders in b-oxidation of mitochondrial fatty acids did not reveal abnormalities in mother or child.