[Liver rupture in pregnancy: a life-threatening complication of the HELLP syndrome].
A 31-year-old primigravida with pre-existent hypertension was admitted at 28.5 weeks gestation with foetal growth retardation. On the third day after admission she developed a 'haemolysis, elevated liver enzymes and low platelets' (HELLP) syndrome with severe pain in the epigastrium. Intrauterine death had occurred and abruptio placentae was suspected. Induction of labour was started with intravenous prostaglandins. The next day the haemoglobin concentration had decreased despite transfusions of red blood cell concentrates. At ultrasound examination, free fluid was detected in the abdomen and at explorative laparotomy a subcapsular liver haematoma appeared to have ruptured. An intrahepatic haematoma does not require operative treatment, unless it has ruptured. Packing of the ruptured liver with gauze and later removal of the gauze is preferable to lobectomy.
Weemhoff
R A
RA
Martini Ziekenhuis, afd. Gynaecologie en Obstetrie, Groningen.
van Loon
A J
AJ
Aarnoudse
J G
JG
D000328:Adult; D005260:Female; D005313:Fetal Death; D017359:HELLP Syndrome / Q000150:complications* / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D011247:Pregnancy; D012422:Rupture, Spontaneous
Ruptuur van de lever in de zwangerschap: een levensbedreigende complicatie bij het HELLP-syndroom.