Liver conditions in pregnancy

Acute fatty liver
This rare condition occurs in the third trimester of pregnancy. Acute fatty deposition in the liver tissue can cause abdominal pain, vomiting and jaundice.
The liver may appear sonographically normal or be diffusely hyperechoic, although focal areas of fatty deposition have also been reported. Acute fatty
liver tends to resolve during the first month of the postpartum period, but may in rare cases progress to cause liver failure.
HELLP syndrome The
HELLP syndrome
is a rare complication of pregnancy occurring in up to 20% of mothers with severe pre-eclampsia.   Haemolytic anaemia (H), elevated liver enzymes (EL) and low platelet count (LP) cause abdominal pain, nausea and fever. Its complications include areas of haemorrhage (either subcapsular haematoma or intraparenchymal bleeding), infarction or necrosis within the liver which can be identified with ultrasound or MRI scanning (Fig. below).
The recognition and prompt diagnosis of acute fatty liver and HELLP syndrome reduce maternal morbidity by enabling emergency caesarean section
to be performed.
image
Ultrasound images Liver infarct in pregnancy in a patient with
HELLP syndrome
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