Acute liver failure (ALF) during pregnancy is a rare but life-threatening condition associated with high maternal and fetal morbidity and mortality. We present a case of a 22-year-old primigravida at 30 weeks gestation who developed ALF with concurrent HELLP syndrome, disseminated intravascular coagulation (DIC), acute kidney injury (AKI), and posterior reversible encephalopathy syndrome (PRES). Despite the complexity of the presentation, a multidisciplinary team comprising obstetricians, intensivist, hepatologist, nephrologist, and neurologist collaborated to provide timely and comprehensive management. This case underscores the importance of a coordinated approach to optimize maternal and neonatal outcomes in such challenging scenarios.

Acute liver failure (ALF) during pregnancy is a rare but life-threatening condition associated with high maternal and fetal morbidity and mortality. We present a case of a 22-year-old primigravida at 30 weeks gestation who developed ALF with concurrent HELLP syndrome, disseminated intravascular coagulation (DIC), acute kidney injury (AKI), and posterior reversible encephalopathy syndrome (PRES). Despite the complexity of the presentation, a multidisciplinary team comprising obstetricians, intensivist, hepatologist, nephrologist, and neurologist collaborated to provide timely and comprehensive management. This case underscores the importance of a coordinated approach to optimize maternal and neonatal outcomes in such challenging scenarios.