Acute Fatty Liver in Pregnancy and the role of vitamin K in the management

Author(s): Biza Akbar


Acute fatty liver of pregnancy is a rare life-threatening complication of pregnancy. Typically presents in the third trimester of pregnancy with a significant maternal and neonatal mortality. We present a unique case of a successful management of 29 years old pregnant patient diagnosed with acute fatty liver of pregnancy with significantly deranged liver function tests. The patient was commenced on vitamin K supplement during pregnancy. In this case, we discussed the importance of correct diagnosis through high index of clinical suspicion and supportive investigations including imaging tests; expediting delivery and adequate supportive care that led to improve prognosis for the mother and the baby. Furthermore, we have explored the role of vitamin K in the management of AFLP. The patient had previous history of pre-eclampsia with her first pregnancy. She had undergone an emergency caesarean section. In this pregnancy she was also diagnosed with gestational diabetes and mild pregnancy induced hypertension in late third trimester. She was delivered by caesarean section at 39 weeks of gestation. The baby weighed 3.8 kg with Apgar score of 9 at 1 minute and 10 at 5 minutes. The Baby was admitted to neonatal intensive care unit due to recurrent prolong episodes of hypoglycaemia, recovered well and discharge home a month later.

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