Acute fatty liver of pregnancy (AFLP) is a severe obstetric emergency requiring immediate, coordinated intervention. The first line of management centres on prompt multidisciplinary stabilisation and delivery. When that initial effort does not achieve its required haematologic and metabolic targets, escalation to a specific liver failure protocol becomes necessary.
First-line management consists of prompt supportive care by the multidisciplinary team, directed at correcting coagulopathy and metabolic derangement (including hypoglycaemia), followed by prompt delivery. When coagulopathy or metabolic derangement — including hypoglycaemia — remain uncorrected prior to delivery, the criteria for escalation to this next-step protocol are met.
Once liver failure is established or progressing, management shifts to targeted hepatic supportive measures. Specific pharmacological and extracorporeal liver-support interventions form part of the approach — the complete structured regimen is available via the link below.