A fatal case of complicated HELLP syndrome and antepartum eclamptic fit with ruptured subcapsular liver hematoma
| Autor: | Ziad S. Abouzaid, Ahmed Samy El-Agwany, Islam Koreim |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine business.industry HELLP syndrome Exploratory laparotomy Obstetrics medicine.medical_treatment medicine.disease Surgery Couvelaire uterus 03 medical and health sciences 0302 clinical medicine Hematoma Obstetrics and gynaecology 030220 oncology & carcinogenesis Atony Genetics medicine Animal Science and Zoology Caesarean section Hemoperitoneum medicine.symptom business |
| Zdroj: | Apollo Medicine. 13:242-244 |
| ISSN: | 0976-0016 |
| DOI: | 10.1016/j.apme.2013.10.001 |
| Popis: | Objective To describe a fatal case of ruptured subcapsular liver hematoma as regards diagnoses and management. Design Case report. Setting Department of Obstetrics and Gynecology. Patient A 25-year-old woman developed HELLP syndrome and antepartum eclamptic fit complicated with ruptured subcapsular liver hematoma during the 28th week of pregnancy. Intervention Midline abdominal exploratory laparotomy, with delivery by caesarean section. Tight abdominal packing for the hematoma and Pringle maneuver were done. Partial couvelaire uterus was managed by prostaglandins and B-Lynch brace sutures to minimize uterine bleeding and atony. The patient developed postoperative hepatic, renal failure, coagulopathy, deterioration and finally death. Conclusion(s) Ruptured subcapsular liver hematoma is a life-threatening condition that should be considered in pregnant women with HELLP syndrome and severe preeclampsia presenting with symptoms and signs of hemorrhagic shock, hemoperitoneum and the liver should be evaluated with ultrasound before delivery. In these patients delivery of the fetus is the first step and the best approach is a midline abdominal incision. Also, regular antenatal care is very important through all trimesters. |
| Databáze: | OpenAIRE |
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