Spontaneous hepatic rupture and maternal death following an uncomplicated pregnancy and delivery

Rupture du foie en péripartum: à propos de huit cas

OBJECTIVES

Subcapsular liver hematoma (SLH) is a serious complication of the preeclampsia and HELLP syndrom. We report eight cases, and we'll precise circumstances of occurrence of this complication, its management and its prognosis.

MATERIALS AND METHODS

Between January 2000 and December 2005, we enrolled eight patients with SLH cases in the intensive care unit of maternity's Ibn Rochd university hospital in Casablanca, Morocco.

RESULTS

The patients are 22 to 41-years-old; six are multiparous, without prenatal care. All are preeclamptic. We diagnosed the SLH in prepartum stage in one case, in operating room in five cases and in post partum stage in two cases. We established blood pressure and homeostasis disturbances, the surgeon made packing for six patients with hepatic artery ligature in two cases. In two other patients, we did only medical care. We noted five deaths, four after hematoma rupture.

CONCLUSION

These results were compared with literature, we need to look for this complication in all-severe preeclampsia with HELLP syndrome, and treat all haemostatic disorders.

Liver and kidney diseases

The spectrum of renal disease in patients with liver disease is expanding. The recognition of renal complications of liver diseases is essential in the management of these patients. As liver transplantation is a treatment option for many patients with chronic liver disease, the presence of renal complications impacts the decision regarding transplantation and influences the course of these patients after transplantation, especially with regard to the use of immunosuppressive therapy. The involvement of the liver and kidney in systemic conditions is common and adds to the morbidity and mortality of patients.