Spontaneous hepatic rupture in pregnancy with initial intrapartum cholestasis of pregnancy

Abstract

Spontaneous hepatic rupture in pregnancy or the puerperium is an extremely rare and life-threatening condition. We present a case in which the patient initially presented with intrahepatic cholestasis of pregnancy and shortly after delivery developed acute spontaneous hepatic rupture. Unlike most other cases, the patient never developed a fulminant syndrome of hemolysis, elevated liver enzymes and low platelet count (HELLP). Early recognition of the syndrome, an aggressive surgical approach with cesarean section and liver packing and blood component therapy contributed to a successful outcome and admission of 27 days.