Korean J Leg Med.  2017 Nov;41(4):141-144. 10.7580/kjlm.2017.41.4.141.

Maternal Death due to Acute Fatty Liver of Pregnancy

• Kwon JH
• Choi M
• Ha H
• Park S

• KMID: 2397689
• DOI: http://doi.org/10.7580/kjlm.2017.41.4.141

Abstract

Acute fatty liver of pregnancy (AFLP) is one of the sudden unexpected causes in pregnancy and maternal deaths. It has been considered as a potential fatal disease in pregnancy, but the postmortem findings of AFLP is not well known. Because an unexpected maternal death may lead to a legal dispute, forensic pathologists should be aware of clinical presentations and postmortem findings of AFLP. Therefore, we presented our case and reviewed with literatures.

Keyword

Acute fatty liver of pregnancy; Maternal death; Forensic pathology; Autopsy

MeSH Terms

Autopsy
Dissent and Disputes
Fatty Liver*
Forensic Pathology
Maternal Death*
Pregnancy*

Figure

• 

  Fig. 1. The cut surface of the liver reveals yellow tan.

• 

  Fig. 2. Macrovesicular and microvesicular fatty changes are identified in liver (H&E, ×200).

Reference

1.Ko H., Yoshida EM. Acute fatty liver of pregnancy. Can J Gastroenterol. 2006. 20:25–30.

2.Rolfes DB., Ishak KG. Acute fatty liver of pregnancy: a clinicopathologic study of 35 cases. Hepatology. 1985. 5:1149–58.

3.Sherlock S. Acute fatty liver of pregnancy and the microvesicular fat diseases. Gut. 1983. 24:265–9.

4.Bernal W., Wendon J. Acute liver failure. N Engl J Med. 2013. 369:2525–34.

5.Hamid SS., Jafri SM., Khan H, et al. Fulminant hepatic failure in pregnant women: acute fatty liver or acute viral hepatitis? J Hepatol. 1996. 25:20–7.

6.Browning MF., Levy HL., Wilkins-Haug LE, et al. Fetal fatty acid oxidation defects and maternal liver disease in pregnancy. Obstet Gynecol. 2006. 107:115–20.

7.Liu J., Ghaziani TT., Wolf JL. Acute fatty liver disease of pregnancy: updates in pathogenesis, diagnosis, and management. Am J Gastroenterol. 2017. 112:838–46.

8.Lindner M., Hoffmann GF., Matern D. Newborn screening for disorders of fatty-acid oxidation: experience and recommendations from an expert meeting. J Inherit Metab Dis. 2010. 33:521–6.

9.Han WS., Seo YS., Im SY. Acute fatty liver of pregnancy with fetal microvesicular hepatic steatosis. Korean J Obstet Gynecol. 2012. 55:649–54.

10.Wilcken B., Leung KC., Hammond J, et al. Pregnancy and fetal long-chain 3-hydroxyacyl coenzyme A dehydrogenase deficiency. Lancet. 1993. 341:407–8.