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    AFLP

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    Adwaitha Kr
    This document summarizes AFLP (acute fatty liver of pregnancy), a serious disorder occurring late in pregnancy that can be fatal for both mother and fetus. It is caused by an autosomal recessive genetic error resulting in an enzyme deficiency that causes the fetus to produce abnormal fatty acid metabolites, leading to maternal microvascular stenosis and potentially liver failure. Clinical features include nausea, vomiting, abdominal discomfort and jaundice. Diagnosis involves signs of preeclampsia and worsening maternal condition. Rapid delivery is essential for management, along with supportive care and correction of any complications. Maternal mortality can be as high as 10% without proper facilities, while perinatal mortality is usually due to preterm birth but can be as high as

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    AFLP

    Uploaded by

    Adwaitha Kr
    15 views13 pages
    This document summarizes AFLP (acute fatty liver of pregnancy), a serious disorder occurring late in pregnancy that can be fatal for both mother and fetus. It is caused by an autosomal recessive genetic error resulting in an enzyme deficiency that causes the fetus to produce abnormal fatty acid metabolites, leading to maternal microvascular stenosis and potentially liver failure. Clinical features include nausea, vomiting, abdominal discomfort and jaundice. Diagnosis involves signs of preeclampsia and worsening maternal condition. Rapid delivery is essential for management, along with supportive care and correction of any complications. Maternal mortality can be as high as 10% without proper facilities, while perinatal mortality is usually due to preterm birth but can be as high as

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    This document summarizes AFLP (acute fatty liver of pregnancy), a serious disorder occurring late in pregnancy that can be fatal for both mother and fetus. It is caused by an autosomal recessive genetic error resulting in an enzyme deficiency that causes the fetus to produce abnormal fatty acid metabolites, leading to maternal microvascular stenosis and potentially liver failure. Clinical features include nausea, vomiting, abdominal discomfort and jaundice. Diagnosis involves signs of preeclampsia and worsening maternal condition. Rapid delivery is essential for management, along with supportive care and correction of any complications. Maternal mortality can be as high as 10% without proper facilities, while perinatal mortality is usually due to preterm birth but can be as high as

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    15 views13 pages

    AFLP

    Uploaded by

    Adwaitha Kr
    This document summarizes AFLP (acute fatty liver of pregnancy), a serious disorder occurring late in pregnancy that can be fatal for both mother and fetus. It is caused by an autosomal recessive genetic error resulting in an enzyme deficiency that causes the fetus to produce abnormal fatty acid metabolites, leading to maternal microvascular stenosis and potentially liver failure. Clinical features include nausea, vomiting, abdominal discomfort and jaundice. Diagnosis involves signs of preeclampsia and worsening maternal condition. Rapid delivery is essential for management, along with supportive care and correction of any complications. Maternal mortality can be as high as 10% without proper facilities, while perinatal mortality is usually due to preterm birth but can be as high as

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    © All Rights Reserved
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    AFLP

    KALYANI S
    ROLL NO : 45
    •This is a serious disorder
    occurring in late pregnancy,
    which is often fatal for both the
    mother and fetus.
    AETIOLOGY
    • First pregnancy
    • Male fetuses
    • Preeclampsia
    • Maternal obesity
    • Multiple pregnancies
    • This is caused by an autosomal recessive
    genetic error.
    • Specific enzyme defect is long chain 3-hydroxyl
    acyl Co A Dehydrogenase (LCHAD) deficiency.
    • Fetus produces abnormal fatty acid metabolites
    which lead to maternal microvascular stenosis
    and in extreme cases liver failure.
    DIAGNOSIS

    • CLINICAL FEATURES : ( THIRD TRIMESTER)


    1. Nausea
    2. Vomiting
    3. Anorexia
    4. Vague abdominal discomfort
    5. Malaise
    6. Followed by jaundice after one week
    • Signs of preeclampsia are present
    • Progressive worsening of maternal conditions
    • In severe cases,there will be endothelial cell activation
    with capillary leakage causing haemo
    concentration,hepato renal problems,ascites and
    pulmonary edema.
    • Still birth can occur
    • Hypoglycemia is common
    • Hepatic encephalopathy,coagulopathy and renal failure
    in 50% cases.
    DIFFERENTIAL DIAGNOSIS

    • Preeclampsia with HELLP Syndrome


    • Viral hepatitis
    INVESTIGATIONS

    • LFT are abnormal with increased serum bilirubin and moderate increase in
    SGOT and SGPT and alkaline phosphatase.
    • Prothrombin time increased
    • Disseminated coagulation failure in severe cases.
    • Haemolysis and thrombocytopenia
    • Increase in uric acid
    • USG shows classic feature of ascites or bright liver
    MANAGEMENT

    • Rapid delivery is essential


    • Multidisciplinary approach involving
    hepatology,nephrologist ,anesthetist and
    intensivists.
    • Prompt initiation of supportive therapy including
    correction of hypoglycemia and transfusion of
    blood products to correct coagulopathy may be
    life saving.
    PROGNOSIS

    • Maternal mortality
    1. Due to hepatic failure leading to hepatic encephalopathy,renal
    failure and coagulopathy.
    2. MR approx. 10% in rural India and centres where facilities for
    management of complications are not available.
    3. MR can be very low in teritiary centres
    4. Liver functions usually returns to normal in a week or may be
    delayed for months
    • Perinatal Mortality
    1. Rates can be as high as 85%
    2. Major cause of perinatal mortality is preterm birth due to urgent
    need for delivery.
    Thank You

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