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Fatal Postpartum Spontaneous Liver Rupture: Case Report and Literature Review


Additional information and reprint requests:
Bobbie Collett Sutton, M.D., Ph.D.
South Bend Medical Foundation, Inc.
530 N. Lafayette Blvd.
South Bend, IN 46601


Abstract:  Maternal hepatic rupture is a rare complication of pregnancy that can be fatal to both mother and child. This phenomenon is most often associated with preeclampsia/eclampsia and/or HELLP syndrome, which is defined by a collection of clinical features including hemolysis (H), elevated liver enzymes (EL), and a low platelet count (LP). These disease processes are typically identified and treated during pregnancy, often in the last trimester. The described case is unusual in that the decedent had no known history of preeclampsia/eclampsia or HELLP syndrome during this pregnancy, and she died suddenly several days postpartum of liver rupture with massive intraperitoneal hemorrhage following a routine cesarean section delivery and an uneventful hospital course. Similar cases are infrequent in the literature, which is reviewed in this report.