• 作者：Francisco Sá ; nchez-Bueno ; ^{sbuenof@um.es} ; Roc&#237 ; o Garc&#237 ; a Pé ; rez ; Gloria Torres Salmeró ; n ; Jezabel Ferná ; ndez-Carrió ; n ; Pablo Ram&#237 ; rez Romero ; Pascual Parrilla Paricio
• 关键词：S&iacute ; ndrome de HELLP ; Trasplante hep&aacute ; tico ; Resecci&oacute ; n hep&aacute ; tica ; Hematoma hep&aacute ; tico
• 刊名：Cirugía Española
• 出版年：2012
• 出版时间：January, 2012
• 年：2012
• 卷：90
• 期：1
• 页码：33-37
• 全文大小：387 K
• ISSN：S0009739X11002995

HELLP syndrome (HS) occurs in 0.5-0.9% of pregnant women. According to the Tennessee criteria, it is characterised by haemolytic anaemia, thrombopenia and multi-organ dysfunction. The purpose of this article is to present the cases of four pregnant women diagnosed with HS with severe liver involvement.

Patients and method

We present the cases of 4 pregnant women of 24, 27, 28 and 36 weeks gestation, respectively. Pregnancy was terminated by urgent Caesarean section in all 4 cases. The first case required a right hepatectomy, with a good post-operative outcome; the second patient developed fulminant liver failure, dying due to multi-organ failure while waiting for a liver transplant. The third patient progressed satisfactorily with conservative medical treatment. The fourth patient required two livers transplants, being discharged from hospital three months later.

Conclusions

When faced with the clinical suspicion of a HS it is essential to rule out a liver haematoma, since the treatment of choice depends on its clinical-radiological severity. If there is a rupture of the haematoma, urgent surgery is essential and, in the case of severe liver failure, a liver transplant is indicated.