Abstract:

Hepatic infarction is an extremely rare and fatal complication associated with HELLP syndrome characterized by hemolysis, elevated liver enzymes, and low platelets. It can develop from acute liver failure and increase maternal and neonatal mortality. A 38-year-old woman with a history of gestational hypertension developed HELLP syndrome after delivery at 31⁺³ weeks of gestation. Multiple organ failure followed. Despite plasma exchange and symptomatic treatment, the patient′s condition gradually deteriorated with sepsis and shock, followed by biliary enzyme isolation and gradual deterioration of liver function. Finally, imaging findings showed extensive liver infarction and she died 21 days after delivery. The management of HELLP syndrome with hepatic infarction should be multidisciplinary. Plasma exchange using fresh frozen plasma is one of the most effective methods, but if liver infarction progresses to irreversible liver damage, liver transplantation as the only radical treatment, if applicable, is worth trying.

Key words: HELLP syndrome, Liver failure, Plasma exchange, Pre-eclampsia, Postpartum period, Case reports