Immediate delivery is recommended for AFLP to reduce maternal and fetal risk.

Immediate delivery is recommended for AFLP to reduce maternal and fetal risk.

• A. Immediate delivery
• B. Delayed delivery until liver enzymes normalize
• C. No delivery, just observation
• D. Delivery after postpartum bleeding risk resolves

Answer: (A)

AFLP is a pregnancy-specific liver disorder that becomes life-threatening if not treated promptly. The definitive treatment is delivery, because removing the placenta eliminates the source of the metabolic stress driving hepatic injury and coagulopathy. Once the baby and placenta are removed, maternal liver function can begin to recover, coagulation factors stabilize with proper supportive care, and fetal risk drops as the placenta-driven pathology is halted. Because AFLP can progress rapidly, delaying delivery in hopes that liver enzymes will normalize is dangerous—the mother and fetus may deteriorate in the meantime. Observation without delivery or delaying delivery for issues unrelated to controlling the placental disease do not address the underlying problem and miss the opportunity to prevent worsening maternal and fetal outcomes.

AFLP is a pregnancy-specific liver disorder that becomes life-threatening if not treated promptly. The definitive treatment is delivery, because removing the placenta eliminates the source of the metabolic stress driving hepatic injury and coagulopathy. Once the baby and placenta are removed, maternal liver function can begin to recover, coagulation factors stabilize with proper supportive care, and fetal risk drops as the placenta-driven pathology is halted. Because AFLP can progress rapidly, delaying delivery in hopes that liver enzymes will normalize is dangerous—the mother and fetus may deteriorate in the meantime. Observation without delivery or delaying delivery for issues unrelated to controlling the placental disease do not address the underlying problem and miss the opportunity to prevent worsening maternal and fetal outcomes.