Liver hematoma and rupture during pregnancy

　　Pregnancy-induced hypertension is the main cause of liver hematoma and rupture, including pre-eclampsia, eclampsia, and HELLP syndrome. In addition, liver tumors, liver abscesses, acute fatty liver, trauma, and other factors can also cause liver hematoma and rupture.

　　The main complications of liver hematoma and rupture during pregnancy include liver and kidney failure, respiratory distress syndrome, pleural effusion, subphrenic infection, and rebleeding after surgery. The symptoms are severe, and patients may experience sudden severe pain in the upper right quadrant of the abdomen, accompanied by abdominal distension, nausea and vomiting, pale complexion, cold sweat, and rapid pulse, which may eventually lead to shock. Abdominal examination shows marked tenderness, peritoneal irritation, and mobile dullness, among other signs. The condition often progresses rapidly, and if not treated promptly, it can be life-threatening.

　　Patients with liver hematoma and rupture during pregnancy may have symptoms such as swelling and pain in the upper right quadrant of the abdomen, tenderness and rebound pain in the liver area. As the condition progresses, due to the excessive stretching of the liver capsule, traction of the liver ligaments, capsule rupture, and the stimulation of bleeding, the pain in the abdomen of the patient intensifies, accompanied by radiation pain in the right shoulder and intra-abdominal hemorrhage. They may also exhibit symptoms and signs of acute hemorrhagic shock.

　　Some patients have a history of combined liver cancer, and they may suddenly develop severe pain in the upper right quadrant of the abdomen, accompanied by abdominal distension, nausea and vomiting, pale complexion, cold sweat, rapid pulse, and eventually shock. Abdominal examination shows marked tenderness, peritoneal irritation, and mobile dullness, among other signs. The condition often progresses rapidly, and if not treated promptly, it can be life-threatening.

　　There is no special preventive method for this disease. The main preventive method is to prevent the primary disease and achieve early detection and early treatment to reduce the occurrence of complications. The prognosis of this disease is good. In recent years, due to the progress of diagnosis and treatment, the mother and child can almost survive completely.

　　For patients with liver hematoma and rupture during pregnancy, imaging examinations are generally required. B-ultrasound examination can see locative lesions in the liver area and subcapsular hematoma or liquid shadow areas, which can be diagnosed clearly. CT scan can be used to see a complete crescent or lens-shaped low-density liquid area under the liver capsule when necessary. Abdominal puncture can be performed during bleeding to extract unclotted blood.

　　There are no special dietary requirements for patients with liver hematoma and rupture during pregnancy. Generally, normal diet is sufficient. Pay attention to a rich and balanced diet, ensuring the needs of calories, proteins, and vitamins for normal human metabolism. Appropriately increase the intake of vegetables and fruits. In terms of health care, pay attention to relaxing the mind, building confidence, maintaining a good attitude, and actively cooperating with the doctor's treatment.

　　The first aid principle for the rupture of liver hematoma bleeding is to correct coagulation function, correct shock, surgical hemostasis, or interventional embolization treatment. Next, I will specifically introduce the treatment principles of this disease:

　　1. Correcting Shock and Coagulation Dysfunction

　　Firstly, a large amount of intravenous fluid should be administered, including fresh blood, fresh plasma, and various coagulation factors. If necessary, a small amount of heparin should be used to correct coagulation dysfunction, prevent further damage to organs such as the liver, kidney, heart, lung, and brain by DIC. Emergency surgery should be performed after the condition stabilizes or blood pressure becomes stable. If the treatment of fluid infusion and blood transfusion is ineffective or the condition worsens, timely surgery for rescue should be performed.

　　2. Surgical Hemostasis

　　According to the specific situation, reasonable hemostatic measures should be taken for hemostasis.

　　3. Postoperative Management

　　Postoperative and postpartum patients should continue to observe and treat strictly, take positive measures to prevent the occurrence of complications, and give corresponding treatment to other primary diseases.