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

INTRODUCTION Acute fatty liver of pregnancy (AFLP) is a maternal liver disease unique to pregnancy. It was first described in 1934 as “yellow acute atrophy of the liver1]” and was described as a specific clinical entity in 19402]. AFLP is a rare, buts…

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

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.