A spectrum of liver diseases can affect women both during pregnancy and after delivery. Four pregnancy-specific liver diseases include:

1. Intrahepatic cholestasis of pregnancy (ICP)
2. Acute fatty liver disease of pregnancy (AFLDP)
3. Haemolysis elevated liver enzymes low platelets (HELLP) syndrome
4. Hyperemesis gravidarum (HG)

Acute fatty liver disease of pregnancy (AFLDP) describes a disease in pregnant women who are carrying foetuses who cannot process or break down certain fats, which consequently accumulate suddenly in the mother’s liver.

Typical symptoms

Symptoms of AFLDP include nausea, jaundice, fatigue and other non-specific symptoms including excessive thirst and abdominal pain. Symptoms in the later stages of pregnancy might involve protein in the urine and high blood pressure.

Diagnosis

Diagnosis is difficult as a consequence of non-specific liver disease symptoms and, as it occurs more frequently in first pregnancies, a woman will not identify symptoms such as fatigue, thirst and nausea which are non-specific symptoms of pregnancy.

Treatment

When diagnosed with AFLDP, a rare and severe disease, a woman must be admitted to hospital and closely monitored. In many cases, an early birth might be necessary, and a Caesarean section birth might be advised.

Incidence

A rare and uncommon disease, AFLDP affects one in 20,000 pregnancies, typically occurring within the last 12 weeks.

Prognosis

In most cases, the woman’s liver will return to normal after birth, though this might take some time. In a small number of cases, pancreatitis (inflammation of the pancreas) might occur, or a liver transplant might be a necessary intervention.