Sharma Ruchira, Park Selena, Lin Ruby, Segal Joshua
Division of Maternal-Fetal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
Eur J Obstet Gynecol Reprod Biol. 2025 Sep;313:114633. doi: 10.1016/j.ejogrb.2025.114633. Epub 2025 Aug 5.
Ruptured subcapsular liver hematoma (SLH) is a rare and life-threatening complication of HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, often mimicking other obstetric emergencies. A 35-year-old gravida 5 para 3 at 36 weeks gestation presented with severe back pain and underwent emergency cesarean for suspected uterine rupture. Intraoperatively, a ruptured SLH was identified. The liver hemorrhage was managed with packing, an Evarrest Fibrin Sealant patch, and massive transfusion protocol (MTP). Postoperative labs confirmed HELLP syndrome. She was discharged on postoperative day eleven following multidisciplinary care. This case illustrates the diagnostic challenges and management complexity of SLH in the setting of HELLP syndrome. Prompt recognition, surgical control, and multidisciplinary coordination were crucial for a successful outcome.
肝包膜下血肿破裂（SLH）是HELLP（溶血、肝酶升高、血小板减少）综合征一种罕见且危及生命的并发症，常酷似其他产科急症。一名35岁、孕5产3、妊娠36周的孕妇因严重背痛就诊，因疑似子宫破裂接受了急诊剖宫产。术中发现了破裂的肝包膜下血肿。肝出血通过填塞、使用Evarrest纤维蛋白封闭剂贴片和大量输血方案（MTP）进行处理。术后实验室检查确诊为HELLP综合征。经过多学科护理，她于术后第11天出院。该病例说明了在HELLP综合征背景下肝包膜下血肿破裂的诊断挑战和管理复杂性。迅速识别、手术控制和多学科协调对于取得成功结果至关重要。
