# Dual Tragedy of Fetal and Maternal Loss: A Case of Acute Liver Failure in the Third Trimester

## TL;DR

This paper describes a tragic case of maternal and fetal loss due to acute liver failure during the third trimester of pregnancy.

## Contribution

The case highlights atypical presentation of preeclampsia without traditional markers like hypertension or proteinuria.

## Key findings

- Autopsy showed an enlarged liver with multiple patchy hemorrhages.
- Histopathology confirmed submassive hepatic necrosis as the cause.
- Early diagnosis and referrals are emphasized for better patient outcomes.

## Abstract

The traditional criteria for diagnosing preeclampsia include a new onset of hypertension and new-onset proteinuria at 20 weeks gestation. However recent studies suggest preeclampsia and even eclampsia may develop in the absence of either proteinuria or hypertension. This paper reports a dual tragedy of maternal and fetal loss after 36 weeks in the third trimester. Autopsy findings revealed an enlarged liver with multiple patchy hemorrhages, and histopathology confirmed submassive hepatic necrosis. Early diagnosis with timely referrals to higher centers is always helpful for the patients in such cases.