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[HELLP syndrome. Hepatic subcapsular hematoma and infarction. 2 cases reports]
D Rodríguez González1, R Velarde Ibarra, E Cortez Alatorre
1Unidad de Cuidados Intensivos Nuevo Hospital Civil de Guadalajara.
Ginecologia Y Obstetricia De Mexico
|April 7, 1998
Summary
HELLP syndrome can cause severe liver complications like hematoma and infarction, often presenting with hypotension. Prompt intervention, including surgical pregnancy termination, is crucial for managing this critical condition.
Area of Science:
- Obstetrics and Gynecology
- Hepatology
- Critical Care Medicine
Background:
- HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe pregnancy complication.
- Hepatic subcapsular hematoma and infarction are rare but serious manifestations of HELLP syndrome.
- Hypotension can be an early indicator of HELLP syndrome severity.
Observation:
- Two cases of HELLP syndrome are presented with documented hepatic subcapsular hematoma and infarction.
- Both patients initially presented with hypotension, necessitating surgical pregnancy interruption.
- Associated complications included leukocytosis, renal insufficiency, severe hepatic failure, and hepatic encephalopathy (grade III-IV).
Findings:
- One patient succumbed to multiple organ failure despite intensive medical management.
- The second patient survived with residual minor liver dysfunction.
- The findings highlight the potentially devastating impact of HELLP syndrome on hepatic and systemic function.
Implications:
- Early recognition of hypotension in HELLP syndrome is critical for timely intervention.
- Aggressive management strategies are required to address multi-organ involvement in severe HELLP syndrome.
- These cases underscore the importance of multidisciplinary care in managing life-threatening obstetric emergencies.