Acute fatty liver of pregnancy: an update on pathogenesis and clinical implications

World J Gastroenterol. 2006 Dec 14;12(46):7397-404. doi: 10.3748/wjg.v12.i46.7397.

Abstract

Acute fatty liver of pregnancy (AFLP) is a serious maternal illness occurring in the third trimester of pregnancy with significant perinatal and maternal mortality. Till recently, it has been considered a mysterious illness. In this editorial, we review the recent advances in understanding the pathogenesis of AFLP and discuss the studies documenting a fetal-maternal interaction with a causative association between carrying a fetus with a defect in mitochondrial fatty acid oxidation and development of AFLP. Further, we discuss the impact of these recent advances on the offspring born to women who develop AFLP, such that screening for a genetic defect can be life saving to the newborn and would allow genetic counseling in subsequent pregnancies. The molecular basis and underlying mechanism for this unique fetal-maternal interaction causing maternal liver disease is discussed.

Publication types

  • Editorial
  • Review

MeSH terms

  • Acute Disease
  • Fatty Acids / metabolism
  • Fatty Liver / complications*
  • Fatty Liver / diagnosis
  • Fatty Liver / etiology
  • Female
  • HELLP Syndrome / diagnosis
  • Humans
  • Infant, Newborn
  • Lipid Metabolism, Inborn Errors / complications
  • Lipid Metabolism, Inborn Errors / diagnosis
  • Maternal-Fetal Exchange
  • Mitochondrial Diseases / complications
  • Mitochondrial Diseases / diagnosis
  • Mitochondrial Diseases / genetics
  • Mitochondrial Trifunctional Protein
  • Multienzyme Complexes / genetics
  • Multienzyme Complexes / metabolism
  • Oxidation-Reduction
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / etiology

Substances

  • Fatty Acids
  • Multienzyme Complexes
  • Mitochondrial Trifunctional Protein