[Spontaneous rupture of the liver in pregnancy. Case study and review of the literature].

The authors report a case of "spontaneous" rupture of the liver in a woman of 35 years of age. This occurred immediately after post-partum eclampsia. It was not possible to obtain complete haemostasis using absorbable haemostatic compresses along the convexity of the liver. Complete cessation of bleeding only occurred after the operation when posterior pituitary abstracts had been transfused. The patient died 53 days after the initial procedure from a high gastro-intestinal haemorrhage. A study of the literature shows that this rare condition is most probably a complication of toxaemia of pregnancy but the physio-pathology of these liver lesions is ill-understood. The clinical picture is in two phases--the first corresponds to the formation of a sub-capsular haematoma and the second to the intra-peritoneal rupture of this haematoma. The prognosis for this condition is poor, the maternal mortality ranging from 56%-75%. The prognosis is linked to the speed with which the diagnosis is made and surgical intervention is carried out. This should be done before the capsule of the liver ruptures. Haemostasis is nearly always best obtained by using haemostatic compression with packs but haemostasis is not always adequate, particularly if there are several lesions in both lobes of the liver. This case history shows that using posterior pituitary abstracts in transfusion can be helpful.