HELLP syndrome complicated by hepatic rupture

Objective: Although spontaneous hepatic rupture associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is rare, it is a life-threatening complication of pregnancy. The cornerstone of prognosis for successful outcome is its prompt diagnosis. Case: We report a case of 34-year-old female at 29 weeks of gestation with spontaneous hepatic rupture caused by HELLP syndrome as a presenting symptom of weakness without right upper quadrant abdominal pain. Conclusion: If there is a pregnant woman who is complaining of weakness accompanying with hypotension, obstetrician should check the patient for the presence of hepatic rupture. Hepatic rupture in HELLP syndrome should be considered as a differential diagnosis in pregnant patients with the complaint of weakness. It usually causes sudden onset of abdominal pain and accompanying hypotension. But as in this case, it may present without abdominal pain. An interdisciplinary surgical approach including supportive measures with the use of temporary packing of the liver to control the bleeding can result in successful outcome.