Spontaneous hepatic haematoma in a pregnant woman during labour

A search in Pubmed, Embase, and Ovid from 2000 to 2017 resulted in 35 cases reported in either pregnant or puerperal women. Hepatic rupture is a rare complication in pregnancy associated with preeclampsia and HELLP syndrome. Its pathophysiology is attributed to the presence of vasospasm due to an increase in concentration and sensitivity to circulating vasopressors during pregnancy. There is no standard management, but surgery reduces mortality significantly. It includes endovascular management, partial hepatectomy, or transplant (only one patient required a liver transplant in our search). The most used techniques have been ligation of the hepatic artery, embolization of the hepatic artery, and examination, packing, and drainage of hepatic lesion for bleeding control (27 cases were treated with laparotomy with evacuation of hematoma and hemostasis and four cases were treated with embolization of the hepatic artery). Hepatic artery occlusion both by surgery ligation and by embolization through interventional radiology has reported successful and failing results during pregnancy Conclusion: Management of pathologies as hepatic rupture associated with severe preeclampsia and HELLP syndrome has to be clearly protocolized for prompt diagnosis and early management. Furthermore, it has to be carried out through multidisciplinary teams in high-complexity obstetrics scenarios.

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Hepatic rupture associated with preeclampsia, report of three cases and literature review

Vidarte

Montes

Pérez

et al. 2018

The Journal of Maternal-Fetal & Neonatal Medicine

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Rotura hepática espontánea en puérpera sin enfermedad hipertensiva del embarazo ni enfermedad hepática: Reporte de caso

Guevara-Ríos,

Torres-Contreras,

Novoa-Reyes

et al. 2023

Investigación Materno Perinatal

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La rotura hepática es una complicación grave de un embarazo con una alta morbilidad y mortalidad, está relacionada frecuentemente con la preeclampsia; excepcionalmente se puede presentar en una gestante sin preeclampsia o síndrome HELLP. Se presenta un caso de una gestante sin preeclampsia ni enfermedad hepática previa que desarrolla una rotura hepática en el puerperio, es diagnosticada oportunamente y manejada quirúrgicamente. La paciente evolucionó favorablemente.

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Spontaneous hepatic haematoma in a pregnant woman during labour

Abstract: notas clínicas0Hematoma hepático espontáneo en gestante a término durante el trabajo de parto Spontaneous hepatic haematoma in a pregnant woman during labour

Cited by 2 publications

References 5 publications

Hepatic rupture associated with preeclampsia, report of three cases and literature review

Hepatic rupture associated with preeclampsia, report of three cases and literature review

Rotura hepática espontánea en puérpera sin enfermedad hipertensiva del embarazo ni enfermedad hepática: Reporte de caso

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