Spontaneous Hepatic Rupture in a Pregnant Woman with Preeclampsia and HELLP Syndrome. (3rd April 2023)

• Record Type: Journal Article
• Authors: Lam, Nguyen Phuoc; Mai, Anh Tuan; Pham, Thanh Chi; Kieu, Hieu Trung; Nguyen, Hien Quang
• Other Names: Waxman Kenneth S. Academic Editor.
• Is Part Of: Case reports in critical care. Volume 2023(2023)
• Publication Date: 2023-04-03
• Subjects: Critical care medicine -- Periodicals; Emergency medicine -- Periodicals; Medical emergencies -- Periodicals; 616.02805
• DOI: 10.1155/2023/6683645
• Languages: English
• ISSNs: 2090-6420

Abstract

Abstract : Spontaneous hepatic rupture is a rare complication associated with preeclampsia and is characterized by hemolysis, elevated liver enzymes, and a low platelet count (HELLP syndrome), with a nonspecific clinical presentation and high mortality rate. We present the case of a 34-year-old primigravida woman in whom spontaneous hepatic rupture associated with HELLP syndrome was accidentally detected during cesarean delivery. The patient was successfully managed with liver packing and transcatheter arterial embolization, followed by plasmapheresis. Spontaneous hepatic rupture should be considered in any HELLP syndrome patient presenting with epigastric or right upper quadrant pain and early signs of hemodynamic instability. A multimodal approach can help achieve good clinical outcomes in patients with this rare presentation.