The risk of recurrence of acute fatty liver of pregnancy - a review of the current literature.

Acute fatty liver of pregnancy is associated with significant maternal and fetal morbidity and mortality. Defects in fatty acid metabolism appear to play a role in pathogenesis, and several pathogenic variants leading to enzyme deficiencies have been associated with the development of acute fatty liver of pregnancy. The risk of recurrence in subsequent pregnancies is unknown. A review of 10 small case series of women with acute fatty liver of pregnancy disclosed only one case of recurrence in 35 subsequent pregnancies. This contrasted with a survey where 5 of 24 women reported recurrent acute fatty liver in subsequent pregnancies. Retrospective and prospective studies examining subsequent pregnancy outcomes following a diagnosis of acute fatty liver of pregnancy would be useful to better define risk and aid in preconception counselling of women who have had a diagnosis of acute fatty liver of pregnancy and wish to consider further pregnancies.