Pregnancy-specific causes of acute liver failure (ALF) include HELLP syndrome — characterised by hemolysis, elevated liver enzymes, and low platelets — and acute fatty liver of pregnancy (AFLP). Both conditions can precipitate severe, life-threatening liver failure, typically arising in the third trimester or the immediate postpartum period.
This protocol covers patients with pregnancy-related ALF attributable to HELLP syndrome or AFLP presenting in the third trimester or immediately after delivery. Supportive care, multidisciplinary management, and prompt delivery of the fetus are central pillars of the initial approach.
When a patient with pregnancy-associated ALF fails to improve after delivery, urgent specialist evaluation at a dedicated hepatology centre becomes a critical next step. The complete structured regimen — including evaluation criteria, escalation pathways, and decision thresholds — is set out in the full protocol.