Abstract
Abstract Rationale: Subcapsular liver hematoma (SLH) is a rare but potentially fatal complication of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. The SLH incidence rate is about 1% to 2% in patients with preeclampsia and HELLP syndrome. Patient concerns: A 28-year-old woman (gravida 3, parity 2) was admitted to the hospital at 26+1 gestation weeks because of upper abdominal discomfort of 2 weeks duration. Diagnoses: The patient was diagnosed with pre-eclampsia and HELLP syndrome. CT scan confirmed the presence of SLH. Interventions: The patient was treated with magnesium sulphate and Glucocorticoid was given for fetal lung maturation. But the blood pressure continued to rise. Cesarean section was performed, and a male infant was delivered with APGAR score 7. Outcomes: SLH resolved after the operation and the patient was discharged 6 days later. The newborn was discharged 1 month later from the intensive care. Lessons: HELLP syndrome complicated with SLH is a life-threatening condition for pregnant women and fetus. The decrease in blood volume due to bleeding can mask the underlying pre-eclampsia and delay the diagnosis and treatment.
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