Gastrointestinal complications of pre-eclampsia.
Gastrointestinal complications of pre-eclampsia can occur and have the risk of being life-threatening for the mother and fetus. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome has been recognized as a complication of pre-eclampsia for decades. Pregnancies complicated by this syndrome require a well-formulated management plan, including assessing and stabilizing the maternal condition as well as evaluating fetal well-being. Patients with HELLP syndrome should receive anti-seizure prophylaxis with magnesium sulfate, treatment for severe hypertension, and correction of coagulopathy, if present. The potential benefits of expectant management of HELLP syndrome in those remote from term and the use of corticosteroids to improve maternal outcome remain experimental. Computed tomography or ultrasound of the abdomen should be performed if a subcapsular hematoma of the liver is suspected. If a ruptured hematoma is confirmed, massive transfusions and laparotomy are indicated. Ischemia associated with pre-eclampsia cannot only damage the liver but also the pancreas and gallbladder.
Barton
John R
JR
Division of Maternal-Fetal Medicine, Central Baptist Hospital, Lexington, KY, USA. jbarton@bhsi.com
Sibai
Baha M
BM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D005260:Female; D017359:HELLP Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy
D000305:Adrenal Cortex Hormones; D008278:Magnesium Sulfate