HELLP sendromunun nadir görülen katastrofik bir bulgusu: Subkapsüler hematom ve/veya hepatik rüptür.

Objective: It was aimed to present cases which developed subcapsular hematoma and/or hepatic rupture associated with hemolysis, increased liver enzymes and thrombocytopenia (HELLP) syndrome in a tertiary center. Methods: The data of patients who applied to the Department of Obstetrics and Gynecology, Faculty of Medicine, Dicle University between January 1995 and December 2012 and whose laboratory parameters were compatible with the diagnosis criteria of HELLP syndrome (platelet count <100 billion/L, aspartate aminotransferase >70 unit/L, lactate dehydrogenase >600 unit/L) were evaluated retrospectively. Patients whose clinical symptoms and radiological view were in favor of subcapsular hematoma and/or hepatic rupture were included in the study. Demographic data of patients such as age, gravida and parity, weeks of gestation, antenatal care history, laboratory parameters (full blood, biochemistry), gynecologic and obstetric histories, systolic-diastolic blood pressures, delivery types, postoperative complications, diagnostic imaging finding, medical and surgical treatments applied and similar data were provided from archive files and electronic database of the hospital. Results: It was found out that 53,217 deliveries were carried out at our clinic during the study (1995-2012). It was seen that there were 6637 (12.47%) deliveries due to pregnancy-induced hypertensive diseases, and among them, 5412 (10.17%) deliveries were preeclampsia, 347 (0.65%) deliveries were eclampsia and 878 (1.65%) deliveries were carried out due to the indication of HELLP syndrome. While the incidence of subcapsular hematoma and/or hepatic rupture in all deliveries was 0.015% (8/53.217), this rate was found 0.91% among the pregnants with HELLP syndrome. Four (50%) of the patients included in our series died. Two of them were reported to die due to intraoperative bleeding after hepatic rupture, and other two cases due to disseminated intravascular coagulation. Conclusion: Subcapsular hematoma and/or hepatic rupture is a lifethreatening catastrophic complication. Life-saving surgical and medical treatment support may be provided such patients with an early diagnosis and multidisciplinary approach in the tertiary centers where they are provided healthcare. [ABSTRACT FROM AUTHOR]