A Case Report of Severe Preeclampsia with HELLP Syndrome and Hepatic Infarction.

Hwang, In Chul; Kim, Bong Seok; Kim, Jong Soo; Sunwoo, Jae Gun; Bae, Dong Han; Kim, Hyun Chul

Case Report

Korean Journal of Obstetrics & Gynecology 2003;46(11):2328-2332.
Published online November 1, 2003.

A Case Report of Severe Preeclampsia with HELLP Syndrome and Hepatic Infarction.

In Chul Hwang, Bong Seok Kim, Jong Soo Kim, Jae Gun Sunwoo, Dong Han Bae, Hyun Chul Kim

¹Department of Obstetrics and Gynecology, Soonchunhyang Chunan hospital, Soonchunhyang University College of Medicine, Chunan, Korea.
²Department of Radiology, Soonchunhyang Chunan hospital, Soonchunhyang University College of Medicine, Chunan, Korea.

Abstract

Liver hematomas, infarction and ruptures complicated with preeclampsia are fatal to pregnant woman and fetus. So, close observation and proper diagnosis are demanded for treatment. Although the incidence of HELLP syndrome in severe preeclampsia and eclampsia woman is about 20%, liver rupture and infarction complicated with HELLP syndrome were reported very rarely in 1/15,000. Of course, liver rupture and infarction could be complicated with normal pregnant women, but the incidence of liver rupture and infarction complicated with HELLP syndrome was higher. Suspicious earliest physical findings of liver rupture and infarction are tenderness and rebound tenderness of right upper quadrant of abdomen. Radiologic evaluations such as liver USG, CT, MRI and angiography would be chosen for proper diagnosis. Treatment of liver rupture and infarction was varied from conservative treatment to surgical treatment like liver transplantation when bleeding was not controlled. The liver infarction complicated with preeclampsia was unusual and fatal to pregnant woman and fetus, so we report a case of liver infarction occured in HELLP syndrome patient with a brief review of literatures.

Key Words: Liver infarction, HELLP syndrome, Preeclampsia