Noriega Ramos N, Estrada Portilla A O
Hospital de Ginecología y Obstetricia No. 3, Centro Médico La Raza, IMSS, México, D.F.
Ginecol Obstet Mex. 1993 Nov;61:311-22.
Hepatocellular hemorrhagic necrosis was found in 11 cases, that correspond to 55% of 20 cases of death due to hypertensive disease of third trimester of pregnancy: eclampsia, in 81.8% was diffuse; in 18.1% it was focal: it was present at 18 years to 38 years of age; at 25.5 years of age, average; 36.3% were primipara, 36.3% multiparae. Subcapsular hepatic hematoma was found in five cases, 60% with intact capsule, and 40% with broken capsule. From the five cases, 60% were multiparae; 80% was developed during the third trimester of pregnancy; 20% during the second trimester; 80% showed pain associated with vomiting; 80% evolutionated towards eclampsia. These five cases of subcapsular hepatic hematoma, in principle, developed a subcapsular hepatic hematoma syndrome; ulteriorly with the development of shock, the subcapsular hepatic hematoma syndrome, appeared, with capsule rupture. We considered the hepatocellular hemorrhagic necrosis, hepatic subcapsular hematoma with intact Glisson capsule, and hepatic hematoma with broken capsule, three stages of the same disease.
在20例妊娠晚期高血压疾病（子痫）死亡病例中，发现11例存在肝细胞出血性坏死，占55%；其中81.8%为弥漫性，18.1%为局灶性；患者年龄在18岁至38岁之间，平均年龄25.5岁；初产妇占36.3%，经产妇占36.3%。发现5例肝包膜下血肿，60%包膜完整，40%包膜破裂。这5例中，经产妇占60%；80%在妊娠晚期发生，20%在妊娠中期发生；80%伴有疼痛和呕吐；80%进展为子痫。这5例肝包膜下血肿，原则上发展为肝包膜下血肿综合征；随后随着休克的发生，出现肝包膜下血肿综合征并伴有包膜破裂。我们认为肝细胞出血性坏死、肝包膜完整的肝包膜下血肿以及肝包膜破裂的肝血肿，是同一疾病的三个阶段。
