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A 24-Year-Old Woman Presenting in the Third Trimester of Pregnancy with Nausea, Vomiting, and Abdominal Pain and Diagnosed with Acute Fatty Liver of Pregnancy.

Abstract
BACKGROUND Acute fatty liver of pregnancy (AFLP) is a rare obstetric emergency that most commonly occurs in the third trimester and has high mortality rates for the mother and fetus. AFLP is a diagnosis of exclusion supported by identifying 6 or more of the 15 Swansea criteria. This report is of a 24-year-old woman presenting in the third trimester of pregnancy with nausea, vomiting, and abdominal pain and diagnosed with AFLP. CASE REPORT A 24-year-old woman presented at 36 weeks of gestation with nausea, vomiting, and abdominal pain. Investigations showed leukocytosis, hyperbilirubinemia, increased liver enzymes, hypoglycemia, hyperuricemia, acute kidney injury (AKI), and coagulopathy. Ten of the 15 Swansea criteria were fulfilled. An emergency cesarean section resulted in the delivery of a healthy infant, followed by a normalization of the mother's liver function. Because long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency in the infant can be associated with maternal AFLP, genotyping of the infant was planned. CONCLUSIONS This report has shown the importance of clinical awareness, rapid diagnosis, and management of AFLP. Screening for fetal LCHAD deficiency could help decrease mortality.
AuthorsWaravudh Naothavorn, Chatsaran Thanapongpibul, Kanin Sriudomporn, Chayatat Ruangkit, Nantaporn Srivanitchapoom, Nuttapat Tungtrongchitr
JournalThe American journal of case reports (Am J Case Rep) Vol. 23 Pg. e937085 (Aug 24 2022) ISSN: 1941-5923 [Electronic] United States
PMID35999773 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Mitochondrial Trifunctional Protein
Topics
  • Abdominal Pain (etiology)
  • Cardiomyopathies
  • Cesarean Section
  • Fatty Liver
  • Female
  • Humans
  • Infant, Newborn
  • Lipid Metabolism, Inborn Errors
  • Mitochondrial Myopathies
  • Mitochondrial Trifunctional Protein (deficiency)
  • Nausea (etiology)
  • Nervous System Diseases
  • Pregnancy
  • Pregnancy Complications (diagnosis, etiology)
  • Pregnancy Trimester, Third
  • Rhabdomyolysis
  • Vomiting (etiology)
  • Young Adult

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