[Hepatic hematoma in HELLP  syndrome].
OBJECTIVE
The purpose of this study was to review our experience with patients having hepatic rupture or hematoma caused by HELLP syndrome.


METHODS
Descriptive simple cross sectional retrospective study. A review was performed of medical records of all patients admitted at our Hospital's intensive care unit having HELLP syndrome during pregnancy or puerperium between February 1999 and February 2010. Patients complicated with hematoma or hepatic rupture were included.


RESULTS
Three cases were identified. The average maternal age was 35 years old and the average gestational age at delivery was 33 weeks. The most frequent signs and symptoms were sudden onset of abdominal pain and shock. A distinctive laboratory finding was anemia. Surgical treatment was omental patching in one of the patients and it was conservative with drainages in the other two cases. Maternal and perinatal mortality were 33 %.


CONCLUSIONS
Based on our experience and the literature review, we can conclude that hepatic hematoma and rupture associated with HELLP syndrome represent a life-threatening complication in which early detection is very important to achieve a proper diagnosis and treatment. Patients should be treated by a multidisciplinary team in reference centers being carefully followed with adequate hemodynamic support and regular images to improve the survival maternal rate.
Servicio de Tocoginecologìa, Hospital Materno Neonatal, Còrdoba, Argentina.
Maida
M
Alassia
Marìa Marta
MM
Buteler
Cecilia
C
Caffaratti
Hector
H
Bollatti
Marìa Marta
MM
Caratti
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D017359:HELLP Syndrome; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008107:Liver Diseases / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012422:Rupture, Spontaneous