title: Spontaneous hepatic rupture in a normotensive monoamniotic twin pregnancy: case report and review of the literature.
abstract: BACKGROUND
  Spontaneous liver rupture during pregnancy is extremely rare, and often associated with hypertensive disorders. Maternal outcomes are poor and morbidity is high.
  
  
  METHODS
  A 27-year-old women (G1P0), pregnant with monochorionic-monoamniotic twins, developed extensive abdominal pain while she was electively admitted at 32 weeks for fetal pulmonary maturation. Diagnosed with preterm labor, a caesarean section was performed. Postoperatively, our patient deteriorated and a second laparotomy revealed an extensive liver rupture. There was no evidence of hypertensive disorders or hepatic tumors. After perihepatic packing and embolization, our patient required long-term treatment in our intensive care unit. She survived, and both mother and children are healthy after 6 months.
  
  
  CONCLUSIONS
  Despite being rare, spontaneous liver rupture in absence of hypertensive disorders during pregnancy is associated with high maternal morbidity and mortality. Adequate treatment requires a multidisciplinary approach.
authors.affiliation: Department of Obstetrics and Gynecology, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Antwerp, Belgium. philipdekoninck@gmail.com
authors.forename: P L J
authors.initials: PL
authors.lastname: DeKoninck
authors.forename: P
authors.initials: P
authors.lastname: Loquet
authors.forename: P
authors.initials: P
authors.lastname: Leyman
authors.forename: J
authors.initials: J
authors.lastname: Van Leemput
authors.forename: O
authors.initials: O
authors.lastname: d'Archambeau
authors.forename: J
authors.initials: J
authors.lastname: Van Wiemeersch
authors.forename: R
authors.initials: R
authors.lastname: Devlieger
mesh_terms: D000328:Adult; D001794:Blood Pressure; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D012422:Rupture, Spontaneous; D014430:Twins, Monozygotic