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Published on: January 26, 2024
Pre-eclampsia/eclampsia and hepatic rupture.
Paulino Vigil-De Gracia1, Luis Ortega-Paz
1Critical Care Unit, Department of Obstetrics and Gynecology, Caja de Seguro Social, Panama City, Panama. pvigild@hotmail.com
Summary
Hepatic hematoma and rupture are serious complications of pre-eclampsia/eclampsia, often linked to HELLP syndrome. Advances in medical care have significantly reduced maternal mortality rates over time.
Area of Science:
- Obstetrics and Gynecology
- Hepatology
- Critical Care Medicine
Background:
- Hepatic hematoma and rupture are rare but life-threatening obstetric emergencies.
- Pre-eclampsia and eclampsia are significant risk factors for these hepatic complications.
Purpose of the Study:
- To review case reports of hepatic hematoma/rupture in women diagnosed with pre-eclampsia or eclampsia.
- To analyze the characteristics, outcomes, and trends of these cases.
Main Methods:
- A systematic review of case reports published between 1990 and 2010.
- Databases searched included MEDLINE, SciELO, and LILACS.
- Inclusion criteria focused on pre-eclampsia/eclampsia with hepatic hematoma/rupture, in English, Spanish, French, or Portuguese.
Main Results:
- 180 cases of hepatic hematoma or rupture were identified.
- 90% involved capsule rupture, and 6.7% were associated with HELLP syndrome.
- Maternal mortality decreased from 22.2% to 16.4% over the study period, while perinatal mortality remained high.
Conclusions:
- HELLP syndrome is a frequent diagnosis in cases of hepatic hemorrhage/rupture.
- Improvements in resuscitation, intensive care, and surgical interventions likely contributed to reduced maternal mortality.
- Liver transplantation and arterial embolization are noted as potential interventions.
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