Sucan Han, Hua Zhang, Liangxi Zhu
Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272000, China.
BMC Pregnancy Childbirth. 2025 Aug 14;25(1):854. doi: 10.1186/s12884-025-08008-x.
When severe preeclampsia progresses to its most severe stage, eclampsia and HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelet syndrome, HELLP syndrome) can occur. The incidence rates of eclampsia and HELLP syndrome are extremely low, and the condition complicated by the rupture of a subcapsular hepatic hematoma is even rarer, which seriously endangers the patient’s life.This article reports a case where a patient gave birth spontaneously outside the hospital, suddenly developed eclampsia, and was complicated by Hellp syndrome and the rupture of a subcapsular hepatic hematoma. During the operation, extensive peeling of the capsule on the diaphragmatic surface of the right lobe of the liver was observed, and the blood loss was approximately 8000 ml. Postoperatively, the important indicators deteriorated rapidly by hundreds of times, leading to hepatorenal failure, a small amount of subarachnoid hemorrhage in the right parietal lobe, a large amount of pleural effusion accompanied by atelectasis. After multiple multidisciplinary case discussions both within and outside the province, the patient was finally cured and discharged from the hospital.Through in-depth analysis of this highly challenging case, this article systematically summarizes its pathogenesis, clinical features, and treatment experience, aiming to provide valuable reference for clinicians and improve their understanding, diagnosis, and treatment levels of such diseases.
当重度子痫前期进展到最严重阶段时，可发生子痫和HELLP综合征（溶血、肝酶升高和血小板减少综合征，HELLP综合征）。子痫和HELLP综合征的发病率极低，并发肝包膜下血肿破裂的情况更为罕见，严重危及患者生命。本文报道1例患者在院外自然分娩后突然发生子痫，并并发HELLP综合征及肝包膜下血肿破裂。术中见肝右叶膈面包膜广泛剥离，出血量约8000ml。术后重要指标迅速恶化数百倍，导致肝肾衰竭，右顶叶少量蛛网膜下腔出血，大量胸腔积液伴肺不张。经省内、外多次多学科病例讨论，患者最终治愈出院。通过对这一极具挑战性病例的深入分析，本文系统总结了其发病机制、临床特点及治疗经验，旨在为临床医生提供有价值的参考，提高其对此类疾病的认识、诊断及治疗水平。
