Medical disorders in pregnancyFree in the app
AFLP vs HELLP
Two liver emergencies of late pregnancy.
Source: Swansea criteria · RCOGClues
| Points to AFLP | Low glucose, marked jaundice, high ammonia, high white cells, early kidney injury, clotting worse than the platelets suggest, thirst, confusion. |
|---|---|
| Points to HELLP | High BP and protein, haemolysis (LDH above 600), platelets below 100, glucose and clotting normal until late. |
Swansea criteria (6 or more of 14)
- Vomiting · abdominal pain · polydipsia/polyuria · encephalopathy
- Bilirubin above 14 µmol/L · glucose below 4 mmol/L · urate above 340 µmol/L
- White cells above 11 · ascites or bright liver on scan · AST/ALT above 42
- Ammonia above 47 · creatinine above 150 · PT above 14 s or APTT above 34 s · microvesicular steatosis
Both: stabilise (glucose, FFP/cryo, BP), then expedite birth. AFLP needs ICU and liver unit input. Test the baby for LCHAD deficiency.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.