Fatty Liver of Pregnancy

Acute fatty liver of pregnancy is more frequently associated with first pregnancies, twin gestations, and male fetuses. It generally occurs late in the third trimester or in the immediate post-partum period. Histologic features include microvesicular steatosis and ballooning hepatocyte degeneration. Note the involvement pericentral hepatocytes (left half) with relative sparing of the periportal hepatocytes (right half).