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Pre‐eclampsia/eclampsia and hepatic rupture
Author(s) -
VigilDe Gracia Paulino,
OrtegaPaz Luis
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.03.042
Subject(s) - medicine , hellp syndrome , eclampsia , obstetrics , pregnancy , hematoma , mortality rate , preeclampsia , surgery , genetics , biology
Objective To review case reports of hepatic hematoma/rupture in women with pre‐eclampsia/eclampsia. Methods MEDLINE, SciELO, and LILACS databases were searched for case reports of pre‐eclampsia/eclampsia with hepatic hematoma/rupture. Only articles written in English, Spanish, French, or Portuguese and published between 1990 and 2010 were reviewed. Results In total, 180 cases of hepatic hematoma or rupture were identified: 18 (10.0%) with subcapsular hematoma without hepatic rupture; and 162 (90.0%) with capsule rupture. Twelve (6.7%) cases were associated with eclampsia plus hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Average age was 30.9 ± 5.0 years, 74/129 (57.4%) women were parous, and cesarean delivery was performed in 132/162 (81.5%) cases. The right lobule was the most frequently affected 77/100 (77.0%). The total maternal mortality rate was 22.2% during the 21 years; however, it decreased to 16.4% in the last decade studied. The perinatal mortality rate was 30.7% and was very similar during the 2 decades. Conclusion HELLP syndrome is a frequent diagnosis (92.8%) in hepatic hemorrhage/rupture. The major reduction in maternal mortality rate was probably associated with advances in resuscitation, intensive‐care medicine, and surgical intervention, including liver transplantation and arterial embolization.