Abstract :
Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening obstetric emergency characterized by microvesicular fat accumulation in hepatocytes, leading to severe liver dysfunction. Its clinical presentation often overlaps with other pregnancy-related disorders, making diagnosis challenging. We report a case of a 23-year-old primigravida at 33.5 weeks of gestation, presenting with jaundice, vomiting, and deranged liver function tests. Despite intensive care and multidisciplinary management, the condition progressed to hepatorenal failure and intrauterine fetal demise. The patient underwent timely delivery, dialysis, and supportive care but was transferred to a higher center due to worsening hepatic encephalopathy. However, she succumbed to her illness two days later. The diagnosis remained unconfirmed as a post-mortem examination was not conducted due to the family's reluctance. This case underscores the severity of AFLP and the critical need for vigilant antenatal care, rapid decision-making, and timely intervention to improve maternal and fetal outcomes. Early recognition and prompt management are essential to prevent rapid deterioration and ensure optimal care.
Keyword :
Acute fatty liver of pregnancy, Pregnancy complications, Hepatorenal syndrome, Maternal-fetal exchange and multidisciplinary care.