Acute pregnancy fatty liver with survival of the mother and child

A case of acute fatty liver as a rare cause of pregnancy-induced jaundice is reported. Near term the 25-year-old patient became rapidly jaundiced. On admission laboratory tests showed signs of incipient coagulopathy and impaired renal function. When fetal vital signs deteriorated cesarean section was performed. After surgery the fullblown picture of disseminated intravascular coagulation developed, with profuse bleeding only controllable by rigorous substitution of plasma factors. Acute hepatic insufficiency with ascites followed. Despite the marked bilirubin elevation the hepatic enzymes were only slightly raised. In addition, acute renal insufficiency, pancreatitis and hyperuricemia developed. Under intensive care the patient recovered slowly and was discharged after 4 weeks with a healthy baby.