Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes

Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective...
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Autor*in:	Ashish Goel [verfasserIn] Chin Lye Ch’ng [verfasserIn] Chundamannil E. Eapen [verfasserIn] Kunissery A. Balasubramanian [verfasserIn] Elwyn Elias [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Acute fatty liver of pregnancy (AFLP) improved survival management protocol

Übergeordnetes Werk:	In: European Medical Journal Hepatology - European Medical Journal, 2016, 6(2018), 1, Seite 72-79
Übergeordnetes Werk:	volume:6 ; year:2018 ; number:1 ; pages:72-79

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ023131020

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520			\|a Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder.
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allfields	(DE-627)DOAJ023131020 (DE-599)DOAJ17c42fd6226f4fbf84d6f80364ebe00b DE-627 ger DE-627 rakwb eng RC799-869 Ashish Goel verfasserin aut Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder. Acute fatty liver of pregnancy (AFLP) improved survival management protocol Diseases of the digestive system. Gastroenterology Chin Lye Ch’ng verfasserin aut Chundamannil E. Eapen verfasserin aut Kunissery A. Balasubramanian verfasserin aut Elwyn Elias verfasserin aut In European Medical Journal Hepatology European Medical Journal, 2016 6(2018), 1, Seite 72-79 (DE-627)875180728 (DE-600)2878394-3 20534221 nnns volume:6 year:2018 number:1 pages:72-79 https://doaj.org/article/17c42fd6226f4fbf84d6f80364ebe00b kostenfrei https://www.emjreviews.com/hepatology/article/acute-fatty-liver-of-pregnancy-better-understanding-of-pathogenesis-and-earlier-clinical-recognition-results-in-improved-maternal-outcomes/ kostenfrei https://doaj.org/toc/2053-4221 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2018 1 72-79
spelling	(DE-627)DOAJ023131020 (DE-599)DOAJ17c42fd6226f4fbf84d6f80364ebe00b DE-627 ger DE-627 rakwb eng RC799-869 Ashish Goel verfasserin aut Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder. Acute fatty liver of pregnancy (AFLP) improved survival management protocol Diseases of the digestive system. Gastroenterology Chin Lye Ch’ng verfasserin aut Chundamannil E. Eapen verfasserin aut Kunissery A. Balasubramanian verfasserin aut Elwyn Elias verfasserin aut In European Medical Journal Hepatology European Medical Journal, 2016 6(2018), 1, Seite 72-79 (DE-627)875180728 (DE-600)2878394-3 20534221 nnns volume:6 year:2018 number:1 pages:72-79 https://doaj.org/article/17c42fd6226f4fbf84d6f80364ebe00b kostenfrei https://www.emjreviews.com/hepatology/article/acute-fatty-liver-of-pregnancy-better-understanding-of-pathogenesis-and-earlier-clinical-recognition-results-in-improved-maternal-outcomes/ kostenfrei https://doaj.org/toc/2053-4221 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2018 1 72-79
allfields_unstemmed	(DE-627)DOAJ023131020 (DE-599)DOAJ17c42fd6226f4fbf84d6f80364ebe00b DE-627 ger DE-627 rakwb eng RC799-869 Ashish Goel verfasserin aut Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder. Acute fatty liver of pregnancy (AFLP) improved survival management protocol Diseases of the digestive system. Gastroenterology Chin Lye Ch’ng verfasserin aut Chundamannil E. Eapen verfasserin aut Kunissery A. Balasubramanian verfasserin aut Elwyn Elias verfasserin aut In European Medical Journal Hepatology European Medical Journal, 2016 6(2018), 1, Seite 72-79 (DE-627)875180728 (DE-600)2878394-3 20534221 nnns volume:6 year:2018 number:1 pages:72-79 https://doaj.org/article/17c42fd6226f4fbf84d6f80364ebe00b kostenfrei https://www.emjreviews.com/hepatology/article/acute-fatty-liver-of-pregnancy-better-understanding-of-pathogenesis-and-earlier-clinical-recognition-results-in-improved-maternal-outcomes/ kostenfrei https://doaj.org/toc/2053-4221 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2018 1 72-79
allfieldsGer	(DE-627)DOAJ023131020 (DE-599)DOAJ17c42fd6226f4fbf84d6f80364ebe00b DE-627 ger DE-627 rakwb eng RC799-869 Ashish Goel verfasserin aut Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder. Acute fatty liver of pregnancy (AFLP) improved survival management protocol Diseases of the digestive system. Gastroenterology Chin Lye Ch’ng verfasserin aut Chundamannil E. Eapen verfasserin aut Kunissery A. Balasubramanian verfasserin aut Elwyn Elias verfasserin aut In European Medical Journal Hepatology European Medical Journal, 2016 6(2018), 1, Seite 72-79 (DE-627)875180728 (DE-600)2878394-3 20534221 nnns volume:6 year:2018 number:1 pages:72-79 https://doaj.org/article/17c42fd6226f4fbf84d6f80364ebe00b kostenfrei https://www.emjreviews.com/hepatology/article/acute-fatty-liver-of-pregnancy-better-understanding-of-pathogenesis-and-earlier-clinical-recognition-results-in-improved-maternal-outcomes/ kostenfrei https://doaj.org/toc/2053-4221 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2018 1 72-79
allfieldsSound	(DE-627)DOAJ023131020 (DE-599)DOAJ17c42fd6226f4fbf84d6f80364ebe00b DE-627 ger DE-627 rakwb eng RC799-869 Ashish Goel verfasserin aut Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder. Acute fatty liver of pregnancy (AFLP) improved survival management protocol Diseases of the digestive system. Gastroenterology Chin Lye Ch’ng verfasserin aut Chundamannil E. Eapen verfasserin aut Kunissery A. Balasubramanian verfasserin aut Elwyn Elias verfasserin aut In European Medical Journal Hepatology European Medical Journal, 2016 6(2018), 1, Seite 72-79 (DE-627)875180728 (DE-600)2878394-3 20534221 nnns volume:6 year:2018 number:1 pages:72-79 https://doaj.org/article/17c42fd6226f4fbf84d6f80364ebe00b kostenfrei https://www.emjreviews.com/hepatology/article/acute-fatty-liver-of-pregnancy-better-understanding-of-pathogenesis-and-earlier-clinical-recognition-results-in-improved-maternal-outcomes/ kostenfrei https://doaj.org/toc/2053-4221 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2018 1 72-79
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authorswithroles_txt_mv	Ashish Goel @@aut@@ Chin Lye Ch’ng @@aut@@ Chundamannil E. Eapen @@aut@@ Kunissery A. Balasubramanian @@aut@@ Elwyn Elias @@aut@@
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callnumber-first	R - Medicine
author	Ashish Goel
spellingShingle	Ashish Goel misc RC799-869 misc Acute fatty liver of pregnancy (AFLP) misc improved survival misc management protocol misc Diseases of the digestive system. Gastroenterology Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes
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topic_title	RC799-869 Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes Acute fatty liver of pregnancy (AFLP) improved survival management protocol
topic	misc RC799-869 misc Acute fatty liver of pregnancy (AFLP) misc improved survival misc management protocol misc Diseases of the digestive system. Gastroenterology
topic_unstemmed	misc RC799-869 misc Acute fatty liver of pregnancy (AFLP) misc improved survival misc management protocol misc Diseases of the digestive system. Gastroenterology
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title	Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes
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title_full	Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes
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author_browse	Ashish Goel Chin Lye Ch’ng Chundamannil E. Eapen Kunissery A. Balasubramanian Elwyn Elias
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title_sort	acute fatty liver of pregnancy: better understanding of pathogenesis and earlier clinical recognition results in improved maternal outcomes
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title_auth	Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes
abstract	Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder.
abstractGer	Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder.
abstract_unstemmed	Acute fatty liver of pregnancy (AFLP) is an uncommon disorder affecting women in late pregnancy. It is increasingly recognised as an important cause of preventable maternal mortality across the world. The pathogenic mechanism of AFLP is now better understood; it appears that a compensated defective fatty acid oxidation becomes overt when metabolic stressors are superimposed on the increased energy demands of late pregnancy. The mother tends to rely more on fats as a source of energy in late pregnancy. This phenomenon may have an evolutionary basis and may explain why AFLP typically occurs in late pregnancy. The Swansea criteria have proven to be useful in early diagnosis of AFLP. Attempts to simplify these criteria further have proved helpful in early recognition of the disease. Although liver biopsy showing microvesicular steatosis of hepatocytes is the pathologic hallmark of AFLP, it is neither necessary nor safe in the antepartum setting. Current management strategies revolve around ensuring urgent delivery of the fetus and anticipating and managing complications of acute liver failure. While early recognition and multidisciplinary management have considerably improved maternal survival in AFLP, fetal outcomes remain poor. The authors postulate a therapeutic intervention to improve fetal outcomes in this disorder.
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title_short	Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes
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Acute Fatty Liver of Pregnancy: Better Understanding of Pathogenesis and Earlier Clinical Recognition Results in Improved Maternal Outcomes

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