VỠ GAN NGUYÊN PHÁT Ở THAI PHỤ TIỀN SẢN GIẬT NẶNG: BÁO CÁO CA BỆNH HIẾM GẶP

Abstract

Spontaneous hepatic rupture is a rare but life-threatening condition that almost exclusively occurs in cases of severe preeclampsia or HELLP syndrome. Some patients present with only mild symptoms before suddenly experiencing severe and rapid circulatory shock. The initial clinical symptoms include epigastric pain and right upper quadrant pain. Due to its rarity, there is currently no standardized diagnostic criterion; diagnosis relies on clinical suspicion combined with imaging studies. Case Report: We report a case of a 34-week pregnant woman with severe preeclampsia superimposed on chronic hypertension who underwent an emergency caesarean section due to fetal distress. During surgery, spontaneous hepatic rupture was detected and successfully managed conservatively. Conclusion: Hepatic rupture is an extremely rare complication of severe preeclampsia during pregnancy. It is a life-threatening emergency that can be fatal if not treated promptly. Clinically, hepatic rupture presents as acute abdominal pain, abdominal distension, vomiting, and shock, usually occurring in the third trimester or immediately postpartum. Managing hepatic rupture during pregnancy is a significant challenge in obstetrics due to its rarity and requires a multidisciplinary approach involving obstetrics, anaesthesiology, hepatobiliary surgery, and intensive care.