scholarly journals A case of massive hepatic infarction in severe preeclampsia as part of the HELLP syndrome

2020 ◽  
Vol 36 ◽  
Author(s):  
Linda El Allani ◽  
Said Benlamkaddem ◽  
Mohamed Adnane Berdai ◽  
Mustapha Harandou
1969 ◽  
Vol 40 (2) ◽  
pp. 177-184
Author(s):  
Julián A. Herrera ◽  
Santiago Vélez Medina ◽  
Rodolfo Molano ◽  
Virna Medina ◽  
Javier E. Botero ◽  
...  

Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women. Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels < 160/110 mm and proteinuria >300 mg/l in 24 hours urine) from the Hospital Universitario del Valle (Cali, Colombia) was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28) and another in which the periodontal intervention was practiced after childbirth (NPIG, N=32). Maternal socio-demographic, medical and periodontal data were obtained. PIG included patients in which supragingival and subgingival cleaning within ultrasonic and manual devices were performed after study inclusion. The progression from mild to severe preeclampsia, eclampsia or HELLP syndrome, the number of days of clinical stability and the percentile of birth-weight adjusted for gestational age were evaluated in both groups. Results: Most of the patients (60%) were multigravids. Gestational age at inclusion was 31.8±1.6 weeks. Chronic periodontitis was a frequent finding (61.7%). Social, demographic, medical and periodontal conditions were similar between both groups. Disease progression to severe preeclampsia, eclampsia or HELLP syndrome was also similar (89.2% PIG versus 84.4%, p=0.65) (OR=1.06 IC 95% 0.87-1.29, p=0.65). Days of clinical stability were similar between the groups (median 10 days , range 1-46, PIG versus 12 days, range 1-59, p=0.57) and the percentile of birth weight adjusted with gestational age had no differences between the groups (median percentil 50 range 5-90 PIG versus percentil 55 range 5-95, p=0.73). Conclusion: Periodontal intervention does not seem to harm the health, the severity or alter the frequency on maternal complications in mild preeclampsia subjects.


Author(s):  
Ahmed SSA Rashwan

Background: The (HELLP) syndrome is a severe health hazard in pregnancy described by elevated liver enzymes, low platelet count and hemolysis. It happens in 0.4 to 0.7% of all gestations and in 10-12% of cases with severe preeclampsia. Patients and methods: The present study was a prospective observational study that was made at Department of Obstetrics and Gynecology, Kasr Al-Ainy University Hospital, Cairo University, from September 2018 – March 2019. It included One Hundred and Thirty pregnant women diagnosed with hypertension in the current pregnancy complicated with severe preeclampsia, or HELLP Syndrome associated with abdominal ascites, recruited from the attendees of the Obstetric Emergency Department. The study was approved by the local institutional review board of the Faculty of Medicine, Cairo University. All ladies signed an informed consent. Results: There were statistically significant differences between the HELLP group and the severe preeclamptic group regarding maternal ICU admission and the need of multiple drugs to control the blood pressure being less in severe preeclampsia group. The need for ICU admission was much higher in the HELLP group (43.1%) compared to the severe preeclampsia group (9.2%) showing statistical significance (P<0.001). Conclusion: Maternal and neonatal sicknesses are elevated between cases with HELLP syndrome. So, early diagnosis and definitive treatment can be made to enhance maternal and neonatal results.


e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Vania Nita Patty ◽  
Diana Ch. Lalenoh ◽  
Debby D. Wuisan

Abstract: Preeclampsia was defined as hypertension in pregnancy that occurs after 20th weeks of pregnancy meanwhile eclampsia is the new onset of a grand mal seizure activity and is one of the complications of preeclampsia. Preeclampsia and eclampsia are still the major causes of high maternal and infant mortality in Indonesia (1.5% -25%). Severe preeclampsia becomes an indication of obstetric patients to be admitted to ICU. This study was aimed to obtain the profile of patients with severe preeclampsia and eclampsia admitted to the ICU and HCU Prof. Dr. R.D. Kandou Hospital. This was a descriptive retrospective study. Data were obtained from the medical records of patients admitted to the ICU and HCU from September 2014 to August 2016. There were 33 patients that met the inclusion criteria consisted of 11 patients (33%) with severe preeclampsia and 22 patients (67%) with eclampsia. Most patients were aged ≤ 25 years and the median length of stay in this study was 2 days. HELLP syndrome was found in 9 patients (27.3%) and DIC in 1 (3%) patient. There were five patients with ventilator and three patients died due to eclampsia. Conclusion: Most patients in this study were patients with eclampsia and the mortality rate was 9.1%.Keywords: severe preeclampsia, eclampsia, ICU, HCU Abstrak: Preeklamsia didefinisikan sebagai hipertensi dalam kehamilan yang terjadi setelah minggu ke- 20 kehamilan, sedangkan eklamsia adalah onset baru aktifitas kejang grand mal dan merupakan salah satu komplikasi dari preeklamsia. Preeklamsia dan eklamsia masih menjadi penyebab utama tingginya angka kematian ibu dan bayi di Indonesia (1,5%-25%). Preeklamsia berat menjadi indikasi pasien obstetri masuk ke ICU. Penelitian ini bertujuan untuk mengetahui gambaran pasien preeklamsia berat dan eklamsia yang dirawat di ICU dan HCU RSUP Prof. Dr. R.D. Kandou. Jenis penelitian ialah deskriptif retrospektif. Data diperoleh melalui data rekam medik pasien yang dirawat di ICU dan HCU periode September 2014 - Agustus 2016 dan didapatkan sebanyak 33 pasien yang memenuhi kriteria inklusi. Total pasien preeklamsia berat ialah 11 orang (33%) dan eklamsia sebanyak 22 orang (67%). Usia ≤25 tahun ialah usia terbanyak dan median lama rawat dalam penelitian ini ialah 2 hari. Kejadian HELLP syndrome pada kasus ini sebanyak 9 orang (27,3%) dan DIC sebanyak 1 orang (3%). Pasien dengan ventilator sebanyak 5 orang dan pasien yang meninggal akibat eklamsia sebanyak 3 orang. Simpulan: Dalam penelitian ini pasien terbanyak ialah pasien eklamsia dengan angka kematian 9,1%. Kata kunci: preeklamsia berat, eklamsia, ICU, HCU


2015 ◽  
Vol 32 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Tugba Kinay ◽  
Canan Kucuk ◽  
Fulya Kayikcioglu ◽  
Jale Karakaya

Author(s):  
Rth. Supraptomo ◽  

ABSTRACT Background: Maternal mortality in Indonesia is caused by multifactors that are both direct and indirect factors. Complications during pregnancy and after delivery, including preeclampsia is the direct cause of 90% of maternal deaths. This case report aimed to describe the anaesthesia management on the incidence of severe preeclampsia to prevent the complications. Subjects and Method: We reported a 33-year-old G3P2A0 woman with 33 weeks of gestational age, diagnosed with severe pre-eclampsia partial HELLP syndrome, fetal dis-tress, type II diabetes mellitus pro SCTP emergency with physical status ASA II. Regional anaesthesia with sub-arachnoid block was performed by using Lidodex 75 mg and fentanyl 25 mcg intrathecally. Results: From the operation process, a baby boy with birth weight 2.900 gram and APGAR Score 7-8-9 was born. Two-hour post operation examination on patient showed compos mentis (consciousness), blood pressure 121/ 80 mmHg, heart rate 64 bpm, respiration rate 20 breath per minute, blood oxygen saturation levels (SpO2) 99% with 3 L/min nasal cannula. Patient was administered to HCU post operation to be monitored vital sign and signs of impending eclampsia. Post-operative refeeding was performed after bowel sound was positive. Conclusion: Selection of appropriate anaesthetic management in severe preeclampsia cases can prevent complications. Keywords: severe preeclampsia, sectio caesaria, regional anesthesia, subarachnoid block Correspondence: R. Th. Supraptomo. Department of Anaesthesiology and Intensive Therapy Dr. Moewardi Hospital. Jl Kolonel Sutarto 132 Jebres, Surakarta, Central Java, 57126. Email: [email protected]. Mobile: +6281329025599. DOI: https://doi.org/10.26911/the7thicph.05.29


Author(s):  
Ashok R. Anand ◽  
Binita H. Shah ◽  
Pratibha Vashisth

Subcapsular liver hematoma is rare complication of severe preeclampsia and HELLP syndrome, thus making it essential for these patients to be followed up in critical and intensive care units for advanced medical support with fluid and electrolyte management and replacement of blood products while treating underlying disorders. Treatment options have to be individualised and vary from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this paper we report a case of ruptured hepatic hematoma in a 35 year old female, few hours within delivery, a complication of severe preeclampsia and HELLP syndrome


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