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The numbers in this series were too small to give any estimate of mortality rates. Nevertheless, the incidence rate contrasts dramatically with an incidence rate of 1 in 16,288 big n plump identified in a recent study big n plump of severe maternal morbidity in the South East Thames region of England6. Some risk factors for the disorder, such as nulliparity and multiple pregnancy have been identified7, but there has been no comprehensive study of the epidemiology of this condition. There has also been no wide-ranging study of the management of the condition worldwide, and several questions remain controversial, such as the role of big n plump liver transplantation and the natural history of the associated liver failure7 8. This study will provide a national picture of the incidence of the disease, its epidemiology and management.
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