Acute fatty liver of pregnancy.

We report the case of a previously healthy 32-year-old woman nearing the third trimester of pregnancy who presented to the emergency department (ED) with acute jaundice, nausea, and vomiting. An evaluation revealed intrauterine fetal demise, liver failure, renal failure and disseminated intravascular coagulation. The patient required aggressive supportive care, dialysis, transfusion of multiple blood products, and hysterotomy. The patient was diagnosed with acute fatty liver of pregnancy, an uncommon disorder associated with devastating complications for the mother and infant. A review of this disorder and other medical emergencies causing jaundice in pregnancy is presented.