CASE 20
A 21-year-old primigravid female at 35-week gestation presents to the hospi-
tal with nausea, vomiting, and malaise over the last several days. Patient has
also noticed that her eyes were turning yellow in color. Her prenatal course has
otherwise been unremarkable. On examination she is found to have elevated
blood pressure, proteinuria, increased liver function tests, prolonged clotting
studies, hyperbilirubinemia, hypofibrinogenemia, and hypoglycemia. A pelvic
ultrasound identified a viable intrauterine pregnancy measuring approximately
35-week gestation. After admission, the mother underwent an emergent
cesarean delivery, and she subsequently developed a worsening hypoglycemia
and coagulopathy and went into hepatic coma with renal failure. After review-
ing all the laboratory results and her clinical picture, the patient was diagnosed
with acute fatty liver of pregnancy.
What is an associated biochemical disorder?
What is the etiology of the hypoglycemia?
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