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"Hepatic rupture in preeclampsia and HELLP syndrome: A catastrophic presentation".
Taiwan J Obstet Gynecol. 2020 Sep; 59(5):643-651.TJ

Abstract

The objective of index study is to review the available literature on hepatic rupture or hematoma in hypertensive disorders of pregnancy to find the incidence, associated risk factors, clinical presentation, mode of management and feto-maternal outcome. Electronic database was searched using hepatic rupture or hematoma in pregnancy, preeclampsia, eclampsia, and HELLP syndrome (Hemolysis, EL: elevated liver enzymes, LP: low platelet count) as key words and literature published since January, 2000 to December, 2018 which met the inclusion criteria was reviewed. A total of 56 articles were reviewed describing 93 cases of hepatic hemorrhage in hypertensive disorders of pregnancy. Treatment varied from conservative management to abdominal packing, hepatic artery embolization, and partial hepatectomy to liver transplantation. Seven out of 93 patients with liver rupture met mortality and in one of them diagnosis was established on autopsy. Unawareness of the hepatic rupture in pregnancy by an obstetrician demands high index of suspicion for diagnosis and requires specialized, focused and exhaustive management for optimal feto-maternal outcome. Laparotomy and perihepatic packing is a viable option in patients with unstable vitals and is feasible even in limited resource settings.Short interval between diagnosis and management may enhance the feto-maternal survival rate and prevent further morbidity or mortality.

Authors+Show Affiliations

Department of Obstetrics & Gynecology, Government Medical College & Hospital, Sector-32, Chandigarh, India. Electronic address: sunitas504@gmail.com.Department of Obstetrics & Gynecology, Government Medical College & Hospital, Sector-32, Chandigarh, India. Electronic address: dr.jyotsna.pmch@gmail.com.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32917311

Citation

Dubey, Sunita, and Jyotsna Rani. ""Hepatic Rupture in Preeclampsia and HELLP Syndrome: a Catastrophic Presentation"." Taiwanese Journal of Obstetrics & Gynecology, vol. 59, no. 5, 2020, pp. 643-651.
Dubey S, Rani J. "Hepatic rupture in preeclampsia and HELLP syndrome: A catastrophic presentation". Taiwan J Obstet Gynecol. 2020;59(5):643-651.
Dubey, S., & Rani, J. (2020). "Hepatic rupture in preeclampsia and HELLP syndrome: A catastrophic presentation". Taiwanese Journal of Obstetrics & Gynecology, 59(5), 643-651. https://doi.org/10.1016/j.tjog.2020.07.003
Dubey S, Rani J. "Hepatic Rupture in Preeclampsia and HELLP Syndrome: a Catastrophic Presentation". Taiwan J Obstet Gynecol. 2020;59(5):643-651. PubMed PMID: 32917311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Hepatic rupture in preeclampsia and HELLP syndrome: A catastrophic presentation". AU - Dubey,Sunita, AU - Rani,Jyotsna, PY - 2020/04/15/accepted PY - 2020/9/12/entrez PY - 2020/9/13/pubmed PY - 2021/7/1/medline KW - Eclampsia KW - HELLP Syndrome KW - Hematoma KW - Hepatic rupture KW - Preeclampsia KW - pre-eclampsia SP - 643 EP - 651 JF - Taiwanese journal of obstetrics & gynecology JO - Taiwan J Obstet Gynecol VL - 59 IS - 5 N2 - The objective of index study is to review the available literature on hepatic rupture or hematoma in hypertensive disorders of pregnancy to find the incidence, associated risk factors, clinical presentation, mode of management and feto-maternal outcome. Electronic database was searched using hepatic rupture or hematoma in pregnancy, preeclampsia, eclampsia, and HELLP syndrome (Hemolysis, EL: elevated liver enzymes, LP: low platelet count) as key words and literature published since January, 2000 to December, 2018 which met the inclusion criteria was reviewed. A total of 56 articles were reviewed describing 93 cases of hepatic hemorrhage in hypertensive disorders of pregnancy. Treatment varied from conservative management to abdominal packing, hepatic artery embolization, and partial hepatectomy to liver transplantation. Seven out of 93 patients with liver rupture met mortality and in one of them diagnosis was established on autopsy. Unawareness of the hepatic rupture in pregnancy by an obstetrician demands high index of suspicion for diagnosis and requires specialized, focused and exhaustive management for optimal feto-maternal outcome. Laparotomy and perihepatic packing is a viable option in patients with unstable vitals and is feasible even in limited resource settings.Short interval between diagnosis and management may enhance the feto-maternal survival rate and prevent further morbidity or mortality. SN - 1875-6263 UR - https://www.unboundmedicine.com/medline/citation/32917311/"Hepatic_rupture_in_preeclampsia_and_HELLP_syndrome:_A_catastrophic_presentation"_ DB - PRIME DP - Unbound Medicine ER -