Everything about Fatty Liver and Pregnancy

In rare cases, pregnancy and fatty liver could co-exist at the same time, usually at 34th to 39th week of pregnancy (but sometimes could occur immediately after delivery).

The medical term of this condition is “Acute fatty liver of pregnancy” or AFLP. It is considered to be life-threatening condition, but the chance to die from the disease has been dramatically decreased in recent years.

Among these rare cases, Acute fatty liver of pregnancy is more common on the first pregnancy, with an increased risk in twin pregnancy.

Acute Fatty Liver of Pregnancy - Fatty-Liver.com

Why AFLP is a source of concern?

This is because both mother and the fetus are at very high risk if AFLP isn’t treated. Liver failure, bleeding, kidney failure, and severe infections can be life threatening. Fortunately, early diagnosis of the disease and taking the proper actions can prevent these conditions from happening.

Acute fatty liver of pregnancy symptoms

  • Nausea and vomiting.
  • Abdominal pain, especially in the upper right.
  • General discomfort.
  • Headache.
  • Fatigue and/or Confusion.
  • Jaundice (yellow color of the skin, eyes and mucous membranes).

How Acute fatty liver of pregnancy is diagnosed?

AFLP symptoms are enough in most cases to diagnose the disease. This is usually done together with a blood test to rule out other diseases and conditions that share the same symptoms.

An ultrasound or CT are also used sometimes to help diagnosing acute fatty liver of pregnancy.

The most accurate way to diagnose AFLP is by a liver biopsy, but it’s not always possible to do during a pregnancy.

Acute fatty liver of pregnancy treatment

The only treatment for the disease is to deliver the baby as soon as possible. Time-frame is critical in order to minimize the risks to both the mother and the baby.

After the delivery the mother needs to be under observation until most of the disease symptoms disappear. In most cases the liver is fully recovered within few weeks.

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  1. Justine
    Justine says:

    I was diagnosed with Acute Fatty Liver of Pregnancy with my first pregnancy. I was 35 weeks gestation and became really sick. It was my first pregnancy, twins and they were males. I weighed 100lbs pre pregnancy so any discomfort starting my third trimester was “normal” as anyone would tell me so I agreed. When I reached 35 weeks I became so uncomfortable I thought I was having false labor and because my OB was an hour away I didn’t waist time going in to get checked. Each time many doctors described that my discomfort was normal and to return home. I went in the hospital 2 times that week and 3 calls to nurse direct. Luckily, there was nurse that happen to be working the same unit all week and had seen me come and go, she advocated for me to the Dr. to run some tests before sending me home. Other than stopping the “Braxton hicks” I was having. It was then that the Dr. and nurses came back saying my “labs were off the charts” and delivered the babies immediately, that is when I was diagnosed with AFLP in 2013 and recovered. It has been 8 years and now I am 14 weeks pregnant I am learning there is a reoccurrence and have spoken with a high risk OB but she seems to contradict herself. One minute she says you’re lucky to be alive and there is a risk of reoccurrence and I have a 50/50 shot this time of survival the next minute she is saying I could probably go full term with this pregnancy under strict supervision. This pregnancy is one fetus and with a different partner. I understand this reduces my risk. I have orderd a DNA testing kit for myself, my partner and also my twin sister and her husband (she’s pregnant too with her first and it’s just one fetus too) (just when you thought life couldn’t get any weirder my identical twin is pregnancy too with this possibly genetic mitochondrial AFLP disorder) anyway my question is what are your thoughts on this? Should I keep going with this pregnancy or terminate it now? I have two boys that need me so I’m not sure if I want to take this “roller coaster” ride and risk reoccurrence of AFLP happening again and I don’t make it or is technology that much better that I have 100% chance of survival now a this point especially now that they know I have it and can catch thing early. What kind of tests should I make sure they are doing? Any information, guidance, help and second opinions will be greatly helpful
    Thank you
    Thank you

  2. Adri
    Adri says:

    I just found out im pregnant 8 weeks to be more clear and before I got pregnant I was diagnosed with fatty liver disease I am so scared now I dont know what to think anymore I read a lot bad stuff about it that make me so nervous about this problem is any answer that can help me out please

      • Kristy beck
        Kristy beck says:

        Hi, I also have fatty liver and have just found out I am pregnant. Does anyone have past experience they could share with me please x thank you

  3. Flo bailey
    Flo bailey says:

    I recently discovered that I’m pregnant in my eighth week. Before I discovered that however, I was diagnosed with a fatty liver. Does this make this pregnancy more high risk? I have had two daughters that as far as I know I did not have this condition with them.

  4. Debra Dixon
    Debra Dixon says:

    Thanks so much for your response. Just one more question please, in your opinion, do women go on to have another pregnancy after having been through this? My daughter-in-law has almost fully recovered, it’s been 7 weeks. She was in really bad shape, she is 31, no other children. Thanks again for talking to me!

    • Mark Bar-Gomel
      Mark Bar-Gomel says:

      Hi Debra,

      There is no one right answer for your question. However, I will try to give you some details that might shed some light.

      Medically, there are no restrictions on getting pregnant again. The fact that she already had the disease tells us that she is in high risk to develop the disease again in her second pregnancy.

      Nevertheless, it’s important to remember that acute fatty liver of pregnancy can develop between 34th to 39th week of pregnancy. If and when it does, you can dramatically reduce the risk of complications by delivering the baby as soon as possible. Any minute that goes by increases the risk to both the mother and the baby.

      If your daughter does decide to get pregnant again, she needs to be at the highest alert, meaning take a routine blood test every few days when she starts to approach week 34.

      I’m not aware of all your daughters medical condition so I cannot advise deeper than this. I highly suggest that your daughter will consult her physician to get an accurate risk assessment.

      Wish you all well,
      Dr. Mark Bar-Gomel

  5. Debra Dixon
    Debra Dixon says:

    I just lost my beautiful granddaughter, to this horrible condition. My daughter-in-law almost died as well. It’s 2014 and this almost seems incomprehensible!!! We did not know she had a fatty liver until it was too late! We don’t know when the baby got sick!! She lived 7 hours then went to Heaven. Life really isn’t fair!! Thanksfor listening!!

    • Mark Bar-Gomel
      Mark Bar-Gomel says:

      Hi Debra,

      I am sorry to hear this about your granddaughter. It’s hard to read about these kind of real-life stories.
      Your daughter probably had a serious complication of the disease, especially if she was pregnant.

      That’s the reason it’s so important to treat it as soon as possible, and the first step doing it is to do a blood test that checks liver enzymes levels. It’s very important during pregnancy. That is the most effective way to diagnose the disease.

      I am again truly sorry about your lose. I wish you and your family a healthy life from now on.

      Dr. Mark Bar-Gomel

  6. natalie
    natalie says:

    Hi, I am 34+2 weeks pregnant and my ALT blood test as come back at 97. Is this quite dangerous to be that high in this stage? I have appointment tomorrow with my doctor to make a plan.

    • Mark Bar-Gomel
      Mark Bar-Gomel says:

      Hi Natalie,

      First of all, congratulations on your pregnancy! I hope that the birth goes smoothly and your baby brings you much joy and happiness!
      Regarding your elevated ALT levels, I’m glad you did took the blood test and found out about this now, before it’s too late.

      ALT level of 97 is high, but it’s not the worst it can be. If treated, there should be no problem with your pregnancy.

      After you give birth, ALT levels should decrease to their normal levels.

      Wish you best wishes!
      Dr. Mark Bar-Gomel


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