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Acute fatty liver of pregnancy is a rare life-threatening complication of pregnancy that occurs in the third trimester or the immediate period after delivery. [1] It is thought to be caused by a disordered metabolism of fatty acids by mitochondria in the fetus, caused by long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency. [2]
ALP activity is significantly increased in the third trimester of pregnancy. [11] This is due to increased synthesis from the placenta as well as increased synthesis in the liver induced by large amounts of estrogens. [11] [12] [13] Levels in the third trimester can be as much as 2-fold greater than in non-pregnant women. [11]
The following are the most common treatments of elevated alkaline phosphatase. [23] Treatment of the underlying condition. Once doctors identify the cause of elevated ALP and diagnose a treatment, the levels of alkaline phosphatase fluctuates back to normal; Removal of medication. Drugs can be associated with increased levels of alkaline ...
Most women with this condition present in the third trimester (although it can present as early as seven weeks) with itching without a rash. Typically, the itching is localized to the palms of the hands and soles of the feet, but can be anywhere on the body. Hallmarks of ICP include the following symptoms: [5] Most common:
Several observations suggest estrogen plays a major role: ICP begins in the third trimester, when estrogen levels are highest, resolves after estrogen levels return to normal post-delivery, and occurs with higher incidence in multiple pregnancies, where estrogen levels are more elevated than usual.
The enzyme alkaline phosphatase (ALP, alkaline phenyl phosphatase, also abbreviated PhoA) is a phosphatase with the physiological role of dephosphorylating compounds. The enzyme is found across a multitude of organisms, prokaryotes and eukaryotes alike, with the same general function, but in different structural forms suitable to the environment they function in. Alkaline phosphatase is found ...
Initial sway, total sway, and sway velocity (see figure for description of variables) are significantly less during the third trimester than during the second trimester and when compared to non-pregnant women. These biomechanical characteristics are possible reasons why falls are more prevalent during the second trimester during pregnancy.
Alkaline phosphatase, placental type is a membrane-bound glycosylated dimeric enzyme, also referred to as the heat-stable form, that is expressed primarily in the placenta, although it is closely related to the intestinal form of the enzyme as well as to the placental-like form. [7]