Amber Latsch recounts organ failure from acute fatty liver of pregnancy

Amber Latsch Describes Postpartum Intubation and Liver Failure in Newsweek Essay

Writing in a first-person essay published by Newsweek, certified nurse midwife Amber Latsch recounted experiencing acute fatty liver of pregnancy at 32 weeks gestation, leading to an urgent cesarean delivery, organ failure, and a week of sedation on a ventilator. Latsch, a 36-year-old resident of Wisconsin, stated that the condition caused kidney and liver failure, a postpartum hemorrhage resulting in hypovolemic shock, and an exploratory laparotomy that required the removal of three liters of blood from her abdomen.

Key Clinical Takeaways:
• Acute fatty liver of pregnancy is a rare hypertensive disorder occurring in roughly 1 in 10,000 to 20,000 pregnancies annually, characterized by hepatic fat accumulation that can progress to organ failure.
• Physical recovery following severe ICU admissions for obstetric complications often requires months of supervised rehabilitation, while psychological processing frequently necessitates specialized therapy.

Clinical Complications and Emergency Delivery at 32 Weeks

Latsch discovered she was expecting twins in 2019, but her pregnancy progressed without major incident until reaching 32 weeks gestation. At that point, she developed severe abdominal pain, nausea, and lethargy, prompting her husband, Garrett, to transport her to the hospital. Laboratory results prompted medical staff to recommend an immediate cesarean section, delivering the twins within 30 minutes. Although the infants were healthy and spent slightly over a month in the neonatal intensive care unit, Latsch’s condition worsened due to a postpartum hemorrhage.

Doctors initially suspected HELLP syndrome, a severe variant of preeclampsia, before diagnosing acute fatty liver of pregnancy. The condition occurs when excessive fat builds up in the liver, impairing hepatic function. Treatment required numerous medications, more than 50 units of blood products, a uterine artery embolization, and an exploratory laparotomy where physicians kept her open with a wound vacuum. Latsch was subsequently sedated and intubated in the intensive care unit for the first seven days of her twins’ lives.

Sedation Causes Latsch to Experience Distressing Visions

While sedated and unable to move or breathe independently, Latsch retained patchy memories of her surroundings. She recalled hearing family members, feeling physical touches such as hair brushing and injections, and receiving visits from colleagues and relatives. However, because she was intubated and could not speak, her brain interpreted ambient sounds and movements through a framework of severe fear and fight-or-flight responses.

Latsch experienced recurring distressing visions, believing her organs were being harvested, that she was lost at sea, or that her infants had been removed and given to another couple. She remained unaware that she was intubated, assuming instead that she was speaking normally and that those around her were ignoring her. Seven days after surgery, medical staff closed her abdomen and extubated her. Her initial recovery involved physical therapy to regain mobility, followed by psychological counseling to address feelings of betrayal and trauma associated with her ICU hallucinations.

Recovery Timeline and Reflections on Maternal Health Privilege

Physical rehabilitation took approximately four months, during which Latsch progressed from assisted standing to walking down hospital corridors. Seven years after the incident, she lives in Wisconsin with her husband and three children. Reflecting on the outcome, Latsch acknowledged survivor’s guilt and noted that her background as a medical professional and access to hospital connections significantly influenced her survival. She stated that without her husband’s intervention and her familiarity with the healthcare system, the outcome could have been fatal.