Spontaneous Hepatic Rupture in a Pregnant Woman with Preeclampsia: An Autopsy Case
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Spontaneous hepatic rupture, which is a complication of hypertension in pregnancy, is extremely rare. However, high maternal and perinatal mortality rates are observed. Several factors, namely, age over 30 years, multiparity, severe preeclampsia, or HELLP syndrome (a group of symptoms which include hemolytic anemia, hepatic enzyme increase, and thrombocytopenia), are associated with this condition. An autopsy case of a woman with twin pregnancy was studied. She was at 36 weeks of gestational age and suffered from the sudden development and rapid progression of hypertension. Moreover, she died because of spontaneous hepatic rupture despite an emergency operation. Autopsy revealed a capsular rupture of the right lobe of the liver with numerous blood clots and hypovolemic signs, such as weak postmortem lividity and palor of the skin and conjunctiva. A close examination of the trunk and liver for the classification of the cause of rupture and an assessment of medical history, such as preeclampsia, are needed during postmortem examination of pregnant women with hepatic rupture or her fetus. To the best of our knowledge, this fatal complication in pregnant women is not yet presented in postmortem examinations in Korea. Thus, we report the findings of this case to share the knowledge.
Abstract
Spontaneous hepatic rupture, which is a complication of hypertension in pregnancy, is extremely rare. However, high maternal and perinatal mortality rates are observed. Several factors, namely, age over 30 years, multiparity, severe preeclampsia, or HELLP syndrome (a group of symptoms which include hemolytic anemia, hepatic enzyme increase, and thrombocytopenia), are associated with this condition. An autopsy case of a woman with twin pregnancy was studied. She was at 36 weeks of gestational age and suffered from the sudden development and rapid progression of hypertension. Moreover, she died because of spontaneous hepatic rupture despite an emergency operation. Autopsy revealed a capsular rupture of the right lobe of the liver with numerous blood clots and hypovolemic signs, such as weak postmortem lividity and palor of the skin and conjunctiva. A close examination of the trunk and liver for the classification of the cause of rupture and an assessment of medical history, such as preeclampsia, are needed during postmortem examination of pregnant women with hepatic rupture or her fetus. To the best of our knowledge, this fatal complication in pregnant women is not yet presented in postmortem examinations in Korea. Thus, we report the findings of this case to share the knowledge.
참고문헌 (10)
- Coelho T, "Hepatic hematomas in pregnancy", Acta Obstet Gynecol Scand, 79, pp.884~886 (2000)
- Matsuda Y, "Spontaneous rupture of the liver in an uncomplicated pregnancy", J Obstet Gynaecol Res, 23, pp.449~452 (1997)
- Henny CP, "A review of the importance of acute multidisciplinary treatment following spontaneous rupture of the liver capsule during pregnancy", Surg Gynecol Obstet, 156, pp.593~598 (1983)
- Rinehart BK, "Preeclampsiaassociated hepatic hemorrhage and rupture: mode of management related to maternal and perinatal outcome", Obstet Gynecol Surv, 54, pp.196~202 (1999)
- 양승부, "Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization", 대한영상의학회지, 63(1), pp.29~32 (2010), 대한영상의학회
- Carlson KL, "Ruptured subcapsular liver hematoma in pregnancy: a case report of nonsurgical management", Am J Obstet Gynecol, 190, pp.558~560 (2004)
- Korean Society of Obstetrics and Gynecology, "Obstetrics", pp.725~754 (2007), Koonja Publisher
- American College of Obstetricians and Gynecologists, "Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists'Task Force on Hypertension in Pregnancy", Obstet Gynecol, 122, pp.1122~1131 (2013)
- Magann EF, "Twelve steps to optimal management of HELLP syndrome", Clin Obstet Gynecol, 42, pp.532~550 (1999)
- Nishimura T, "injury associated with chest compression in cardiopulmonary arrest patients", Trauma Cases Rev, 2, pp.024~ (2016)