We report the case of a 44-year-old multiparous patient with 3 previous pregnancies during her fourth pregnancy, at 33 WA the patient presented signs of decompensation of a previously unknown chronic liver disease. During her last months of pregnancy the diagnosis was made after the appearance of signs of hepatocellular insufficiency aggravated by hepatic encephalopathy in the immediate postpartum period. Abdominal ultrasound revealed a liver of chronic hepathopathy with abundant ascites and portal hypertension. Further abdominal CT scan confirmed the presence of a dysmorphic liver with bumpy contours associated with collateral perigastric venous circulation and homogeneous splenomegaly. The evolution was favorable marked by the delivery of a healthy female new born baby and the resumption of a normal state of consciousness of the woman.