Successful management of a case of eclampsia complicated by HELLP syndrome and its sequelae

When severe preeclampsia progresses to its most severe stage, eclampsia and HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelet syndrome, HELLP syndrome) can occur. The incidence rates of eclampsia and HELLP syndrome are extremely low, and the condition complicated by the rupture of a subcapsular hepatic hematoma is even rarer, which seriously endangers the patient’s life.This article reports a case where a patient gave birth spontaneously outside the hospital, suddenly developed eclampsia, and was complicated by Hellp syndrome and the rupture of a subcapsular hepatic hematoma. During the operation, extensive peeling of the capsule on the diaphragmatic surface of the right lobe of the liver was observed, and the blood loss was approximately 8000 ml. Postoperatively, the important indicators deteriorated rapidly by hundreds of times, leading to hepatorenal failure, a small amount of subarachnoid hemorrhage in the right parietal lobe, a large amount of pleural effusion accompanied by atelectasis. After multiple multidisciplinary case discussions both within and outside the province, the patient was finally cured and discharged from the hospital.Through in-depth analysis of this highly challenging case, this article systematically summarizes its pathogenesis, clinical features, and treatment experience, aiming to provide valuable reference for clinicians and improve their understanding, diagnosis, and treatment levels of such diseases.