What is the recommended management for AFLP?

What is the recommended management for AFLP?

• A. Immediate delivery
• B. Observation and rest
• C. Immediate liver transplant
• D. Prolonged bed rest

Answer: (A)

Immediate delivery is the best management for Acute Fatty Liver of Pregnancy. The liver injury in AFLP is driven by the ongoing pregnancy, so removing the fetus and placenta removes the trigger and allows the mother's liver to recover. After diagnosis, delivery should be expedited with careful maternal stabilization first—this includes correcting hypoglycemia with IV glucose, addressing coagulopathy and bleeding risks (often with blood products as needed), and providing ICU-level support for any renal or hepatic dysfunction. Maternal liver function and coagulation typically improve after delivery over the next several days, so continued supportive care is the main course after the baby is delivered. Observation or rest would not treat the underlying problem and could allow deterioration, and liver transplantation is not the initial approach for AFLP—it's reserved for rare cases of fulminant hepatic failure that do not improve after delivery.

Immediate delivery is the best management for Acute Fatty Liver of Pregnancy. The liver injury in AFLP is driven by the ongoing pregnancy, so removing the fetus and placenta removes the trigger and allows the mother's liver to recover. After diagnosis, delivery should be expedited with careful maternal stabilization first—this includes correcting hypoglycemia with IV glucose, addressing coagulopathy and bleeding risks (often with blood products as needed), and providing ICU-level support for any renal or hepatic dysfunction. Maternal liver function and coagulation typically improve after delivery over the next several days, so continued supportive care is the main course after the baby is delivered.

Observation or rest would not treat the underlying problem and could allow deterioration, and liver transplantation is not the initial approach for AFLP—it's reserved for rare cases of fulminant hepatic failure that do not improve after delivery.