Symptoms and diagnosis
for acute fatty liver of pregnancy
Go to A&E if you get a yellow colour to your skin or eyes or get very confused, forgetful or start acting out of character. But most symptoms of acute fatty liver of pregnancy are very general. Many of them are also symptoms you might have due to your pregnancy. It’s important to tell your midwife if any symptoms are bothering or worrying you – for example they don’t go away or are very severe.
If your pregnancy care team think you could have acute fatty liver of pregnancy, they will do tests quickly to find out for sure. It is important to diagnose and treat acute fatty liver of pregnancy as soon as possible.
The information on this page is for:
- Adults with acute fatty liver of pregnancy or suspected acute fatty liver of pregnancy.
- Family, friends, carers, and healthcare professionals.
On this page:
Symptoms of acute fatty liver of pregnancy
cute fatty liver of pregnancy damages your liver. If you have any of the symptoms below go to A&E:
- Your skin or eyes get a yellow colour (jaundice)
- Confusion, forgetfulness, acting out of character or similar changes – these are caused by hepatic encephalopathy (HE) which is when liver damage affects your brain
Women can have symptoms of acute fatty liver of pregnancy for a few weeks before they become very ill. It is often hard to spot because they are caused by lots of other things – including pregnancy. The most common symptoms include:
- Feeling or being sick
- Tummy pain
- Peeing a lot
- Feeling very thirsty
- Feeling very tired (fatigue)
- Itching
Try not to worry too much if you notice any of these things. Acute fatty liver of pregnancy is very rare so you are unlikely to have it. Tell your midwife or doctor about any symptoms that are worrying or bothering you, or if things just don’t feel right. They can find out what’s happening and get you any treatment you need.
Tests for acute fatty liver of pregnancy
If you could have acute fatty liver of pregnancy, doctors will diagnose you as quickly as possible.
You will have an ultrasound scan to look at your liver. This can show doctors whether there is a high amount of fat in your liver.
You will have blood tests for viral hepatitis. This is also a cause of sudden liver failure, so doctors need to rule it in or out as soon as possible.
You will also have blood tests to check for signs of liver damage, including:
- Bilirubin
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
- Creatine
- Ammonia
- Urea
- Glucose
- Blood count
- Blood clotting time
You can find out more about liver blood tests here. Most women do not need to have a liver biopsy. Doctors only do this if there isn’t another way to be sure whether you have acute fatty liver of pregnancy.
The doctors will look at your symptoms and test results and compare them to a list called the Swansea Criteria. If you have 6 or more that match, it’s likely that you have acute fatty liver of pregnancy.
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This content was last reviewed: December 2025
Our expert reviewers:
We would like to thank everyone who helped with creating and reviewing this page. Including Professor John Dillon, Professor of hepatology and gastroenterology, School of medicine, University of Dundee and all our patient reviewers.
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Everyone’s experience of liver disease will be different. Always talk to your specialist medical team for personal advice.
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