DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204844

Ruptured subcapsular hepatic hematoma complicating severe preeclampsia with haemolysis, elevated liver enzymes, low platelet count syndrome: a case report

Ashok R. Anand, Binita H. Shah, Pratibha Vashisth

Abstract


Subcapsular liver hematoma is rare complication of severe preeclampsia and HELLP syndrome, thus making it essential for these patients to be followed up in critical and intensive care units for advanced medical support with fluid and electrolyte management and replacement of blood products while treating underlying disorders. Treatment options have to be individualised and vary from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this paper we report a case of ruptured hepatic hematoma in a 35 year old female, few hours within delivery, a complication of severe preeclampsia and HELLP syndrome


Keywords


Subcapsular hepatic hematoma, HELLP syndrome, Disseminated intravascular coagulation

Full Text:

PDF

References


Dyke RW. The liver in pregnancy in Hepatology: A Text Book of Liver Disease. 2nd ed. Newyork: Wiley & Sons; 1990:1408-8.

Westengaard L. Spontaneous rupture of the liver in pregnancy. Acta Obstet Gynecology. 1983;59:559-61.

Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth. 2009;9:8.

Abercrombie J. Case of hemorrhage of the liver. London Medical Gazette. 1844;34:792-4.

Dessole S, Capobianco G, Virdis P, Rubattu G, Cosmi E, Porcu A. Hepatic rupture after cesarean section in a patient with HELLP syndrome: a case report and review of the literature. Archives of Gynecology and Obstetrics. 2007;276(2):189-92.

Ndzengue A, Hammoudeh F, Brutus P, Ajah O, Purcell R, Leadon J, et al. An obscure case of hepatic subcapsular hematoma. Case Rep Gastroenterol. 2011;5(1):223-26.

Cernea D, Dragoescu A, Novac M. HELLP syndrome complicated with postpartum subcapsular ruptured liver hematoma and purtscher-like retinopathy. Case Reports in Obstetrics and Gynecology. 2012;2012:4.

Carlson KL, Bader CL. Ruptured subcapsular liver hematoma in pregnancy: a case report of nonsurgical management. Am J Obstet Gynecol. 2004;190(2): 558-60.

Barton JR, Sibai BM. Care of the pregnancy complicated by HELLP syndrome. Gastroenterology Clinics of North America.1992;21(4):937-50.