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[HELLP syndrome with severe liver dysfunction: a presentation of three cases].

Francisco Sánchez-Bueno1, Rocío García Pérez, Gloria Torres Salmerón

  • 1Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen Arrixaca, Murcia, España. sbuenof@um.es

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Summary

HELLP syndrome (HS) in pregnancy can cause severe liver issues. Prompt diagnosis and management, including surgery or liver transplant for severe cases, are crucial for maternal outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Hepatology
  • Critical Care Medicine

Background:

  • HELLP syndrome (HS) affects 0.5-0.9% of pregnancies.
  • Characterized by haemolytic anaemia, thrombocytopenia, and multi-organ dysfunction per Tennessee criteria.
  • Focus on severe liver involvement in HS cases.

Observation:

  • Presents four cases of pregnant women with HS and severe liver disease.
  • Gestational ages ranged from 24 to 36 weeks.
  • Interventions included urgent Caesarean section, right hepatectomy, conservative treatment, and liver transplantation.

Findings:

  • One patient required hepatectomy with good recovery.
  • Another experienced fulminant liver failure and multi-organ failure, awaiting transplant.
  • Conservative management was successful for one patient.
  • One patient underwent two liver transplants.

Implications:

  • Clinical suspicion of HS necessitates ruling out liver hematoma.
  • Treatment choice depends on clinical-radiological severity.
  • Ruptured hematoma requires urgent surgery.
  • Severe liver failure in HS may indicate liver transplantation.