During pregnancy, some women experience a sudden and severe liver condition known as acute liver failure (ALF). This condition is characterized by a sudden onset of coagulopathy (problems with blood clotting) and encephalopathy (brain dysfunction). ALF during pregnancy can be attributed to pregnancy-related causes or unrelated liver injuries that coincide with pregnancy.
A study conducted by the U.S. Acute Liver Failure Study Group, involving 33 liver centers, looked at 70 cases of ALF or acute liver injury (ALI) occurring during pregnancy over two decades. The aim was to understand the causes, clinical features, and outcomes of these cases.
Key Findings:
- Of the 70 cases reviewed, 35 were considered pregnancy-associated acute liver disease (PAALD). Among these cases, nearly half were attributed to conditions like HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) and acute fatty liver of pregnancy (AFLP).
- The study noted that most women with PAALD had already given birth before being referred to hepatology specialists, often through cesarean section.
- Acetaminophen toxicity was found to be the cause in 21 cases, while other causes included various factors unrelated to pregnancy, excluding viral hepatitis.
- Recovery with delivery or supportive measures was possible in most cases, but a significant number (16%) required liver transplantation, and some cases (11%) resulted in death.