Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It may present with nonspecific signs and symptoms, none of which are diagnostic, and can mimic pulmonary embolism of cholecystitis. There is no consensus on the management of subcapsular liver hematoma. Unruptured liver hematoma can be conservatively managed. When rupture occurs, surgical, endovascular approaches and, rarely, liver transplantation, may be required. Actual literature is scant and retrospective in nature. Data on follow-up, time to resolution and outcome of subsequent pregnancies are very limited. We here review the diagnosis and management of liver hematoma.

URL: https://www.clinicaltrials.gov. Unique identifier: NCT01095939.

No abstract

C ardiovascular diseases are the leading cause of death in women, and hypertension is one of the most important risk factor for their development.1 Coronary heart disease mortality is higher in women compared with men, 2 and heart disease death rates now seem to be increasing in women 3 as does the prevalence of hypertension. 4 Case-control and cohort studies consistently report that preeclampsia, a pregnancy-specific disorder, is predictive of future cardiovascular, cerebrovascular, and end-stage renal diseases. 5,6 Women with early onset or severe preeclampsia and preterm delivery are at particularly high risk of cardiovascular disease later in life, including during the premenopausal period.7 A history of preeclampsia should, therefore, be considered when evaluating the risk of cardiovascular disease in women.It is still uncertain whether the association between preeclampsia and cardiovascular disease is explained by adverse effects of preeclampsia itself on target organs or by underlying risk factors that predispose women to both preeclampsia and later cardiovascular and renal diseases. Blood pressure (BP) response to variations in salt intake, known as salt sensitivity, is considered as an independent marker for increased cardiovascular risk. [8][9][10] Salt sensitivity is traditionally defined as an increase in office BP of 5% to 10% or an increase in mean ambulatory BP (ABP) of ≥4 mm Hg with an increase in sodium intake.11 Several factors contribute to the development of salt sensitivity in humans, including aging and changes in renal function, and also hormonal and genetic factors. [12][13][14] The profile of sex hormones has also been shown to affect the salt sensitivity of BP. 15,16 In previous studies, we have shown that women are salt resistant before menopause or when receiving oral contraceptives, 17 but they become salt sensitive after menopause. 18 That observation might be explained by the aging effect but also by the change in hormonal profile as salt sensitivity also develops in younger women with surgical menopause. 19 In the present study, we hypothesized that part of the elevated risk of cardiovascular disease in women with a history of severe preeclampsia may be related to salt sensitivity of BP. To this purpose, we assessed the salt sensitivity of BP in women with a history of severe or early onset preeclampsia Abstract-Cardiovascular diseases are the principal cause of death in women in developed countries and are importantly promoted by hypertension. The salt sensitivity of blood pressure (BP) is considered as an important cardiovascular risk factor at any BP level. Preeclampsia is a hypertensive disorder of pregnancy that arises as a risk factor for cardiovascular diseases. This study measured the salt sensitivity of BP in women with a severe preeclampsia compared with women with no pregnancy hypertensive complications. Forty premenopausal women were recruited 10 years after delivery in a case-control study. Salt sensitivity was defined as an increase of >4 mm Hg in 24-hour ambulatory ...