1/115. Liver rupture postpartum associated with preeclampsia and hellp syndrome.Liver rupture is a rare perinatal complication with high maternal mortality. In a multiparous woman with preeclampsia and hemolysis, Elevated Liver enzymes, and Low platelet count (HELLP) syndrome, liver rupture was suspected 10 h after a cesarean section. laparotomy revealed liver rupture which was treated by perihepatic packing. Eventually, the mother was discharged with her baby 88 days after admission. Clinical symptoms, maternal hemodynamics by Swan-Ganz monitoring, and laboratory findings were not predictive until the emergency situation and the consecutive complications required multidisciplinary management.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
2/115. dexamethasone-facilitated postponement of delivery of an extremely preterm pregnancy complicated by the syndrome of hemolysis, elevated liver enzymes, and low platelets.OBJECTIVE: patients with severe preeclampsia and the syndrome of hemolysis, elevated liver enzymes, and low platelets (hellp syndrome) are at increased risk for perinatal and maternal morbidity, especially in very preterm gestations. When this condition affects a pregnancy on the cusp of viability, a therapeutic intervention to prolong gestation without undue risk to the mother or fetus could be beneficial. METHOD: A single case report and review of the literature. Result: We report a patient with hellp syndrome in whom antenatal administration of high-dose dexamethasone helped achieve disease stabilization and delivery postponement for 9 days of a very preterm fetus estimated to weight less than 600 g. Both mother and infant did well postpartum. CONCLUSION: Administration of antenatal high-dose dexamethasone can be used in carefully selected preterm patients with hellp syndrome to delay delivery while in utero fetal maturation is accelerated and the maternal condition is optimized. This can be beneficial in carefully selected pregnancies without apparent adverse maternal or perinatal impact.- - - - - - - - - - ranking = 5.5keywords = liver (Clic here for more details about this article) |
3/115. Spontaneous intrahepatic hemorrhage and hepatic rupture in the hellp syndrome: four cases and a review.Subcapsular hemorrhage and hepatic rupture are unusual catastrophic complications of the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. A high index of suspicion and prompt recognition are keys to proper diagnosis and management of affected patients. The optimal management of these patients is evolving. An aggressive multidisciplinary approach has considerably improved the morbidity and mortality associated with these complications. We present our experience with four cases of hepatic hemorrhage occurring in association with the hellp syndrome and review the literature on this subject. All of our patients were multiparous, and three had a history of eclampsia/preeclampsia in a previous pregnancy. All four patients developed intrahepatic hemorrhage; two developed hepatic rupture requiring surgical intervention. Three patients developed disseminated intravascular coagulation and acute renal failure. Two patients developed pericardial effusion, pleural effusions, and ascites. One patient died of septic complications after multiple surgical interventions.- - - - - - - - - - ranking = 0.5keywords = liver (Clic here for more details about this article) |
4/115. hellp syndrome with antepartum pulmonary edema--a case report.A 44-year-old pregnant female with a gestation of 29 weeks suddenly developed abdominal pain, nausea, vomiting, and laboratory study showed anemia, elevated liver enzymes, and lower platelets. hellp syndrome was diagnosed and urgent delivery was needed. In order to correct the plasma volume and platelet deficiency, 6 units of both fresh frozen plasma and platelets, were given before operation. However, acute pulmonary edema was noted in the antepartum period. After vigorous treatment, she gave birth to a male infant. The postoperative course was smooth and she and her baby were discharged eleven days later. This case reminded us once again of the importance and necessity of invasive monitoring in fluid management of these patients.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
5/115. Persistant pre-eclampsia post partum with elevated liver enzymes and hemolytic uremic syndrome.The spectrum of complications with pre-eclampsia, which may include AFLP (acute fatty liver of pregnancy) as well as the hellp syndrome (hemolysis, elevated liver enzymes, and low platelets), is resolved by early delivery. However, the ravages of HUS/TTP (hemolytic uremic syndrome/thrombotic thrombocytopenic purpura) require therapy usually by plasma exchange. Overlap between these two groups of syndromes has occurred on rare occasions and usually requires the therapy of the predominant or more dangerous or threatening form. Such overlap can be appreciated and then treated successfully without residual morbidity. The index case is presented and an extensive review of the two groups of syndromes is provided.- - - - - - - - - - ranking = 11.792357548877keywords = fatty liver, liver, fatty (Clic here for more details about this article) |
6/115. Intensive-care management of a patient with hellp syndrome--case report.hellp syndrome belongs to the group of pathological states known as pregnancy-induced hypertension or EPH gestosis. The basic criteria for establishing the diagnosis are as follows: H for hemolysis, EL for elevated liver enzymes and LP for low platelets. A pregnant woman, 38 years of age, multipara (V pregnancy, third delivery) has been admitted to the Clinic of gynecology and obstetrics in Novi Sad in 36-37 week gestation complaining of nausea, vomiting, epigastric pain, general weakness, exhaustion as well as symptom of previously diagnosed preeclampsia. Due to signs of fetal distress, the patient has undergone urgent cesarean section, giving birth to a female premature newborn infant. Twenty-four hours after delivery all symptoms and signs hellp syndrome manifested. Being in a critical state, the patient has been transferred to the Institute of Surgery, Clinic of anesthesiology and intensive care with signs of multiple organ failure. With this case report of a patient with hellp syndrome, we wished to point to importance of continual intensive clinical follow-up, laboratory monitoring and corresponding therapeutic procedures, and at the same time to this relatively rare syndrome.- - - - - - - - - - ranking = 1.5keywords = liver (Clic here for more details about this article) |
7/115. Hepatic infarction in preeclampsia as part of the hellp syndrome: CT appearance.We describe the computed tomographic (CT) findings of hepatic infarctions in two preeclamptic pregnant women. These infarcts were part of the hellp syndrome (hemolysis, elevated liver function tests, and low platelets count). In both cases, CT disclosed features characteristic of multiple nonenhancing, low-attenuation, peripheral lesions with vessels coursing through and a mottled appearance. The recognition of such CT findings in liver disease associated with preeclampsia can establish the correct diagnosis.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
8/115. Highly abnormal maternal inhibin and beta-human chorionic gonadotropin levels along with severe HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome at 17 weeks' gestation with triploidy.A 17-week pregnancy complicated by severe hypertension is reported. The fetus had multiple anomalies and was found to have triploidy. Assay of maternal serum markers for trisomy 21 revealed elevated levels of inhibin (137.51 multiples of the median) and human chorionic gonadotropin (41.51 multiples of the median).- - - - - - - - - - ranking = 2keywords = liver (Clic here for more details about this article) |
9/115. Spontaneous hepatic rupture in pregnancy.The HELLP-syndrome (haemolysis, elevated liver enzymes, low platelets) is associated with pre-eclampsia and may cause subcapsular liver haematomas. When hepatic rupture occurs the mortality of mother and unborn is high. rupture remains a surgical emergency with control of bleeding based on trauma principles. We report a case and discuss the diagnosis and management.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
10/115. hellp syndrome with haemaglobin vasospasm.The syndrome of haemolysis, elevated liver enzymes and low platelets (hellp syndrome) is a life threatening, severe complication of pre-eclampsia with typical laboratory findings. An unusual case of a 36-year-old woman with hellp syndrome and the initial complication of intracerebral haemorrhage is presented. The diagnosis of hellp syndrome was confirmed by elevated liver enzymes, low platelets, increased total bilirubin and increased lactate dehydrogenase. The intracranial haematoma was removed with good neurological recovery ensuing. However, this case was complicated by cerebral vasospasm on the eleventh day, confirmed by cerebral angiography and computer tomographic findings. The patient died from brain swelling. Possible vasospam should be considered during the treatment of patients with hellp syndrome.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
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