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| AFLP - "Haematoxylin and eosin staining. Hepatocytes show a clear cytoplasm (arrow) or many minute vacuoles (arrowhead) consistent with steatosis. In the inset, the appearance of conventional macrosteatosis as seen in steato-hepatitis." [http://www.thelancet.com/journals/lancet/article/PIIS0140673609614951/images?imageId=gr5§ionType=green&hasDownloadImagesLink=true] |
Acute Fatty Liver of Pregnancy, or AFLP, is a rare, and sometimes genetic disease affecting pregnant women. Around 1 in 7000 to 1 in 15,000 pregnant woman are affected by AFLP, which is an accumulation of fatty acid in the liver cells. It usually occurs in the third trimester of pregnancy (35-36th week on average) or soon after delivery and would deteriorate further if left untreated.
AFLP is believed to be caused by the deficiency of the enzyme LCHAD in the fetus, which results in abnormal mitochondrial fatty acid metabolism in the liver in the mother. Deficiency of this enzyme, which occurs in the fetus, will cause unmetabolised fatty acids to re-enter maternal circulation through the placenta. This overwhelms the beta-oxidation enzymes and causes the abnormal fatty acid metabolism.
The occurrence of AFLP is more common when the mother is having her first baby, twins or when the child is a boy. Recurrence on the same mother is unlikely, unless it is caused by genetic which is calculated to be 25%. AFLP can be fatal to either the fetal or the mother.85% was the initial mortality rate for both mother and fetus, however with the medical advancement in recent years, maternal and neonatal mortality have decreased to 12.5%-18% and 7-66% respectively.
References:
Wikipedia, the free encyclopedia. 2012. Acute fatty liver of pregnancy. [ONLINE] Available at: http://en.wikipedia.org/wiki/Acute_fatty_liver_of_pregnancy. [Accessed 17 January 2013].
ITV1. (2007). Interview with ITV on "This Morning"
with Phil and Fern. [Online Video]. 15 October. Available from:
http://www.acutefattyliverofpregnancy.co.uk/pageID_7446878.html. [Accessed: 17
January 2013].
Michael J Barsoom,
MD, FACOG. 2012. Acute Fatty Liver of Pregnancy-Epidemiology. [ONLINE]
Available at: http://emedicine.medscape.com/article/1562425-overview#a0199.
[Accessed 17 January 2013].
http://www.thelancet.com/journals/lancet/article/PIIS0140673609614951/images?imageId=gr5§ionType=green&hasDownloadImagesLink=true
http://www.thelancet.com/journals/lancet/article/PIIS0140673609614951/images?imageId=gr5§ionType=green&hasDownloadImagesLink=true
Does this disease affect all ethnic groups or is it more prevalent in certain people?
ReplyDeleteIt would have been better if this post was posted together with the other posts, or if the other posts were also placed at the top bar for easier navigation. Didn't manage to find the 'about' post after scrolling through everything only to realize it was on top LOL.
But overall, the pictures made things easier to understand, so great job done! ^^
As of research now, it does not specifically affect any ethnic groups. It will only be more prevalent if it's cause by genetic with both parents having the mutated gene, causing the child with both mutated gene inherited from the parent as shown in our causes post.
DeleteThanks for advice! :)
Are there any precautions or factors to take note of after the fetus as given birth and both the mother and child survive?
ReplyDeleteAlso, are the fetus normally of natural birth or by caesarean section?
Your case study is very interesting! well done :)
It is best for the mother and child to be under specialist or hospital observation for a few weeks in order to ensure that they are well enough to be discharged. In our case study, the patient stayed in hospital for 3 weeks, while her child stayed for a month. Mothers usually recover faster after delivery than their child/children if no complications occur during the delivery and few days after delivery.
DeleteThe baby would usually be delivered by caesarean section as he/she needs to be delivered as soon as possible. Natural birth takes a longer time and this delay might be harmful for both mother and child.
Thank you!