Spontaneous Hepatic Rupture in a Pregnant Woman with Preeclampsia: An Autopsy Case.
10.7580/kjlm.2017.41.2.46
- Author:
Ji Hye PARK
1
;
Young Seok LEE
;
Yeon Ho OH
;
Se Min OH
;
Hyeong Geon KIM
;
Joo Young NA
Author Information
1. Forensic Medicine Division, National Forensic Service Gwangju Institute, Jangseong, Korea.
- Publication Type:Case Report
- Keywords:
Liver;
Spontaneous rupture;
Pregnancy-induced hypertension;
Autopsy
- MeSH:
Anemia, Hemolytic;
Autopsy*;
Classification;
Conjunctiva;
Emergencies;
Female;
Fetus;
Gestational Age;
HELLP Syndrome;
Humans;
Hypertension;
Hypertension, Pregnancy-Induced;
Hypovolemia;
Korea;
Liver;
Parity;
Perinatal Mortality;
Pre-Eclampsia*;
Pregnancy;
Pregnancy, Twin;
Pregnant Women*;
Rupture*;
Rupture, Spontaneous;
Skin
- From:Korean Journal of Legal Medicine
2017;41(2):46-50
- CountryRepublic of Korea
- Language:English
-
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.
