[Hepatic hematoma in HELLP syndrome]

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

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.

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 %.

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.