| Journal: | Ginecología y obstetricia de México |
| Database: | PERIÓDICA |
| System number: | 000413089 |
| ISSN: | 0300-9041 |
| Authors: | Acosta Martínez, M Covarrubias Haiek, F Garteiz, D1 Vieyra Cortés, D2 Kably Ambe, A2 |
| Institutions: | 1Universidad Nacional Autónoma de México, Ciudad de México. México 2Hospital Angeles de las Lomas, Ciudad de México. México |
| Year: | 2017 |
| Season: | Mar |
| Volumen: | 85 |
| Number: | 3 |
| Pages: | 212-215 |
| Country: | México |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Caso clínico |
| Spanish abstract | La ruptura hepática es una complicación inusual, pero potencialmente mortal, que sucede en 1 de cada 100,000 a 250,000 embarazos. La mortalidad materna se ha reportado en 86% de los casos. En las pacientes con síndrome de HELLP debe considerarse que la manifestación de un hematoma hepático puede culminar en ruptura hepática y muerte. CASO CLINICO: Paciente de 46 años de edad, con antecedente de embarazo gemelar doble, bicorial, biamniótico de 36.5 semanas y preeclampsia severa, posterior a ruptura hepática por síndrome de HELLP y muerte de ambos fetos. El último embarazo evolucionó sin problemas y finalizó en cesárea en la semana 37, sin complicaciones materno-fetales, por lo que fue dada de alta del hospital al tercer día y posteriormente evolucionó sin incidentes. CONCLUSIONES: La atención médica multidisciplinaria y la infraestructura hospitalaria permitieron que la paciente no perdiera la vida debido a la ruptura hepática y hemorragia grave. La hipertensión durante el embarazo es una de las principales causas de muerte materna en todo el mundo; por tanto, es importante concientizar a las pacientes para que acudan a control prenatal regularmente y orientarlas acerca de la hipertensión y sus complicaciones. Los ginecoobstetras deben considerar que la ruptura hepática es una complicación muy grave, con consecuencias fatales para la madre y el feto |
| English abstract | Hepatic rupture is a potentially fatal rare complication, which is diagnosed in 1 of each 100,000 to 250 000 pregnancies. Maternal mortality has been reported in up to 86% of the patients. In cases where there has been a diagnosis of HELLP syndrome, the presence of a hepatic hematoma has to be suspected since it could lead to a hepatic rupture and eventually death. CLINICAL CASE: 46 year old female in late stage of pregnancy, following a hepatic rupture caused by HELLP syndrome and fetal demise of both fetuses in previous twin pregnancy. Her last pregnancy being of normal evolution, having been submitted to cesarean section without complications on her 37th week of gestation, and discharged on her third post-operative day showing a good evolution. CONCLUSION: The multidisciplinary medical attention given to the patient, as well as the hospital infrastructure, allowed the patient to be kept in good health despite the hepatic rupture and hemorrhage presented. It is important to remember that one of the leading causes of maternal death around the world is hypertension during pregnancy. Therefore, patients have to be made conscious of the significance and importance of attending prenatal care on a regular basis and be given information on hypertension and its complications. Additionally, it is important that obstetricians keep in mind that although this is a rare complication, it can lead to a fatal outcome when presented |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Gastroenterología, Ginecología y obstetricia, Embarazo, Preeclampsia, Eclampsia, Síndrome HELLP, Ruptura hepática |
| Keyword: | Medicine, Gastroenterology, Gynecology and obstetrics, Surgery, Pregnancy, Preeclampsia, Eclampsia, HELLP syndrome, Hepatic rupture |
| Full text: | Texto completo (Ver HTML) |
