Spontaneous Hepatic Rupture in a Pregnant Woman with Preeclampsia: An Autopsy Case

Abstract

Spontaneous hepatic rupture, which is a complication of hypertension in pregnancy, is extremely rare. However, high maternal and perinatal mortality rates are observed. Moreover, it is frequently associated with severe preeclampsia or HELLP syndrome (a group of symptoms that include hemolytic anemia, hepatic enzyme increase, and thrombocytopenia). About 80% of the cases involve women who are in their thirties and with a medical history of multiparity and gestational hypertension [1-3]. Its surgical treatments include drainage, hepatic artery ligation, and resection of intrahepatic hematoma. In addition, conservative treatments, such as simultaneous intravenous fluid, transfusion with hemostasis via radiologic hepatic artery embolization, are available. In cases of hepatic hemorrhage, a mortality rate of up to 30% is observed, and liver transplantation may be considered to save a patient’s life [4]. Herein, a case of a woman with twin pregnancy was studied. She experienced gestational hypertension that rapidly developed into preeclampsia and eventually Korean J Leg Med 2017;41:46-50 https://doi.org/10.7580/kjlm.2017.41.2.46