A case report of refractory hepatic impairment following eclampsia
10.3760/cma.j.cn113903-20241224-00850
- VernacularTitle:子痫后难治性肝损害1例
- Author:
Yunfang YAN
1
;
Qigang YANG
;
Xiaofeng WU
;
Xuan LI
;
Zongzhi YIN
Author Information
1. 安徽医科大学第一附属医院妇产科，合肥 230022
- Publication Type:Journal Article
- Keywords:
Eclampsia;
HELLP syndrome;
Hepatic impairment;
Artificial liver support;
Cytomegalovirus
- From:
Chinese Journal of Perinatal Medicine
2025;28(12):1150-1154
- CountryChina
- Language:Chinese
-
Abstract:
This report described a case of eclampsia complicated by hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with refractory hepatic impairment. The patient presented at 34 +6 weeks' gestation with convulsions and impaired consciousness for over 3 hours, accompanied by severe hypertension [240/120 mmHg (1 mmHg=0.133 kPa)]. Emergency cesarean delivery was performed at a local hospital. On postoperative day 2, the patient was transferred to our institution due to sharp transaminase elevation, hepatic failure, and coagulopathy. Although treated with artificial liver support, anti-infection therapy, and organ protection measures, hepatic parameters showed intermittent rebounds. Subsequent detection of cytomegalovirus in bronchoalveolar lavage fluid and blood prompted targeted antiviral therapy, which significantly improved hepatic injury. Through multidisciplinary management, the patient recovered and was discharged 43 days postpartum. Although multiple artificial liver sessions provided limited hepatic function improvement, this case offers valuable insights for managing refractory hepatic impairment in pregnant women, regardless of whether viral infection represented a primary etiology or secondary complication.
