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Hepatic rupture in hemolysis, elevated liver enzymes, low platelets syndrome.
Obstet Gynecol. 2012 Mar; 119(3):617-25.OG

Abstract

OBJECTIVE

Rupture of hepatic hematoma associated with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is a catastrophic complication of pregnancy. Maternal and fetal mortality rates are still high despite advances in diagnosis and treatment. We aimed to present our experience at two referral centers for hepatic disease and to compare it with cases from the literature.

METHODS

We reviewed nine cases that occurred over the past 6 years in our centers and made an extensive literature review covering the past 10 years. We reviewed and compared multiple outcomes for all these cases.

RESULTS

The median maternal age of our patients was 29 years (interquartile range 27-32). Embolization treatment was used with seven of nine (78%) of our patients compared with 5 of 88 (6%) in the literature (P<.001). Our maternal and fetal mortality rates were 0% (95% confidence interval [CI] 0-34%) and 30% (95% CI 7-65%), respectively, compared with 17% (95% CI 10-26%) and 38% (95% CI 31-52%]) from our review of the literature from 2000 to 2010.

CONCLUSION

The use of hepatic artery embolization to address hepatic rupture associated with HELLP syndrome may help minimize morbidity and maternal mortality.

Authors+Show Affiliations

Centre Hospitalier de l'Université de Montréal, Montreal, Quebéc, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22353961

Citation

Grand'Maison, Sophie, et al. "Hepatic Rupture in Hemolysis, Elevated Liver Enzymes, Low Platelets Syndrome." Obstetrics and Gynecology, vol. 119, no. 3, 2012, pp. 617-25.
Grand'Maison S, Sauvé N, Weber F, et al. Hepatic rupture in hemolysis, elevated liver enzymes, low platelets syndrome. Obstet Gynecol. 2012;119(3):617-25.
Grand'Maison, S., Sauvé, N., Weber, F., Dagenais, M., Durand, M., & Mahone, M. (2012). Hepatic rupture in hemolysis, elevated liver enzymes, low platelets syndrome. Obstetrics and Gynecology, 119(3), 617-25. https://doi.org/10.1097/AOG.0b013e318245c283
Grand'Maison S, et al. Hepatic Rupture in Hemolysis, Elevated Liver Enzymes, Low Platelets Syndrome. Obstet Gynecol. 2012;119(3):617-25. PubMed PMID: 22353961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatic rupture in hemolysis, elevated liver enzymes, low platelets syndrome. AU - Grand'Maison,Sophie, AU - Sauvé,Nadine, AU - Weber,Florence, AU - Dagenais,Michel, AU - Durand,Madeleine, AU - Mahone,Michèle, PY - 2012/2/23/entrez PY - 2012/2/23/pubmed PY - 2012/4/19/medline SP - 617 EP - 25 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 119 IS - 3 N2 - OBJECTIVE: Rupture of hepatic hematoma associated with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is a catastrophic complication of pregnancy. Maternal and fetal mortality rates are still high despite advances in diagnosis and treatment. We aimed to present our experience at two referral centers for hepatic disease and to compare it with cases from the literature. METHODS: We reviewed nine cases that occurred over the past 6 years in our centers and made an extensive literature review covering the past 10 years. We reviewed and compared multiple outcomes for all these cases. RESULTS: The median maternal age of our patients was 29 years (interquartile range 27-32). Embolization treatment was used with seven of nine (78%) of our patients compared with 5 of 88 (6%) in the literature (P<.001). Our maternal and fetal mortality rates were 0% (95% confidence interval [CI] 0-34%) and 30% (95% CI 7-65%), respectively, compared with 17% (95% CI 10-26%) and 38% (95% CI 31-52%]) from our review of the literature from 2000 to 2010. CONCLUSION: The use of hepatic artery embolization to address hepatic rupture associated with HELLP syndrome may help minimize morbidity and maternal mortality. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/22353961/Hepatic_rupture_in_hemolysis_elevated_liver_enzymes_low_platelets_syndrome_ L2 - https://doi.org/10.1097/AOG.0b013e318245c283 DB - PRIME DP - Unbound Medicine ER -