Objective: Rupture of hepatic hematoma associated with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is a catastrophic complication of pregnancy. Maternal and fetal mortality rates are still high despite advances in diagnosis and treatment. We aimed to present our experience at two referral centers for hepatic disease and to compare it with cases from the literature.
Methods: We reviewed nine cases that occurred over the past 6 years in our centers and made an extensive literature review covering the past 10 years. We reviewed and compared multiple outcomes for all these cases.
Results: The median maternal age of our patients was 29 years (interquartile range 27-32). Embolization treatment was used with seven of nine (78%) of our patients compared with 5 of 88 (6%) in the literature (P<.001). Our maternal and fetal mortality rates were 0% (95% confidence interval [CI] 0-34%) and 30% (95% CI 7-65%), respectively, compared with 17% (95% CI 10-26%) and 38% (95% CI 31-52%]) from our review of the literature from 2000 to 2010.
Conclusion: The use of hepatic artery embolization to address hepatic rupture associated with HELLP syndrome may help minimize morbidity and maternal mortality.
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http://dx.doi.org/10.1097/AOG.0b013e318245c283 | DOI Listing |
Transfus Med
December 2024
Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, India.
Introduction: The quality of packed red blood cells (PRBC) is influenced by various factors such as the collection and processing method, storage conditions, type of bag materials used, anticoagulant properties, and donor characteristics. Studies have indicated that haemolysis in stored RBC bags is linked to male sex, older age, high haemoglobin count, and increased body mass index (BMI). The study's primary objective was to investigate whether a high BMI, as per Asian Pacific criteria among donors, is associated with an elevated haemolysis rate in stored RBC.
View Article and Find Full Text PDFWorld J Nephrol
December 2024
Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan.
Pregnancy in women with lupus, particularly those with lupus nephritis (LN), carries an increased risk of adverse outcomes. Women with active LN at the time of conception are at a high risk of poor maternal and fetal outcomes. Recent studies indicate that even in the presence of quiescent disease, factors such as hypertension and positive lupus anticoagulant are predictors of worse pregnancy outcomes.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
December 2024
From the Department of Surgery (J.T.R.), and Blood, Heart, Lung, and Immunology Research Center (J.T.R., K.E.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Surgery (A.J.R., A.B., A.R.B., R.A.C.), University of California Davis, Sacramento, California; Department of Anesthesia and Critical Care (A.M., N.N.), Pontchaillou University Hospital of Rennes, Rennes, France; Department of Anesthesiology and Perioperative Medicine (J.D.R.), University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; and Division of Pulmonary Critical Care Medicine, Department of Medicine (K.E.R.), University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Background: Cell-free hemoglobin (CFH) and free heme are potent mediators of endotheliopathy and organ injury in sepsis, but their roles in other hemolytic pathologies are not well-defined. A prime example is trauma where early hemolysis may initiate damage and predict outcome. Here, we investigated the presence of plasma CFH, heme, and their major scavengers after traumatic injury.
View Article and Find Full Text PDFCureus
November 2024
Radiology, Epsom and St Helier NHS Trust, London, GBR.
Subcapsular liver haematoma in pregnancy, a rare and life-threatening condition, is more commonly associated with severe preeclampsia and haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. The common presenting symptom of subcapsular haematoma is acute-onset upper abdominal pain in patients suffering from preeclampsia; shock is the presenting feature in severe cases of rupture. Here we have discussed a case of subcapsular haematoma associated with HELLP syndrome in a patient who responded to conservative management.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Faculty of Healthcare Sciences, Eastern University of Sri Lanka, Chenkaladi, Sri Lanka.
Background: Naphthalene is an aromatic hydrocarbon that potentially produces methemoglobinaemia but rarely causes hemolysis, especially in children with underlying glucose-6-phosphate dehydrogenase deficiency. Although ingestion of a single moth ball by an older child may not be life threatening, it can be fatal if ingested by a toddler.
Case Presentation: A 2-year-old Singhalese boy developed acute severe hemolysis and methemoglobinaemia following ingestion of a mothball.
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