Hiccups, Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome and Hepatic Hematoma

Abstract

Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, which affects 0.2-0.9% of pregnancies, is one of the most difficult obstetric complications to manage. Affected patients can decompensate acutely, and there are a myriad of possible etiologies to evaluate and treat. Serious complications of HELLP syndrome are disseminated intravascular coagulopathy, abruptio placentae and acute renal failure, which are often interdependent. We describe a rare complication of HELLP that manifested itself in an unusual presentation: right shoulder pain, right upper quadrant pain and hiccups which progressed to fetal intolerance of labor due to an acute expansion of a large liver hematoma. This case represents a unique manifestation of the syndrome that provokes further questions in the evaluation and management of patients affected by HELLP syndrome.




J Med Cases. 2014;5(4):234-237
doi: http://dx.doi.org/10.14740/jmc1285w