Severe hepatic rupture in HELLP syndrome

Czech version

Authors: H. Y. Nghiemová ; M. Mojhová ; Michal Zikán
Authors‘ workplace: Gynekologicko-porodnická klinika 1. LF UK a FN Bulovka, Praha
Published in: Ceska Gynekol 2023; 88(2): 100-105
Category: Case Report
doi: https://doi.org/10.48095/cccg2023100

Overview

Objective: To describe the multidisciplinary approach that led to the successful management of severe hepatic rupture in HELLP syndrome at 35 weeks of gestation. Case report: The clinical course and management procedure of a 34-year-old female patient with ruptured liver due to HELLP syndrome, who was admitted with symptoms lasting about 4 hours (pain in the right hypochondrium, nausea, vomiting, flashes before the eyes) are described in the form of a case report. An acute caesarean section was performed, during which a rupture of the subcapsular hematoma of the liver was diagnosed. Subsequently, the patient developed hemorrhagic shock and coagulopathy with the need for repeated surgical revisions of bleeding from the rupture of the liver. Conclusion: Subcapsular hematoma rupture is a rare but serious complication of HELLP syndrome. This case shows the importance of early diagnosis and prompt termination of pregnancy in the shortest possible time in pregnancy after 34 weeks. The most fundamental factor that influenced the patient‘s outcome and morbidity was the management of multidisciplinary cooperation and the correct timing of individual steps.

Keywords:

HELLP syndrome – preeclampsia – rupture of subcapsular hematoma of the liver

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