Subcapsular haematoma of the liver in pregnancy: Report on 4 cases

Abstract

The case histories of 4 patients who developed a subcapsular haematoma of the liver with rupture of the capsule are presented. One patient survived the condition  and the findings in this patient were similar to those in a case presented by previous authors. The incidence of this condition at Baragwanath Hospital is 1 in 40000  deliveries. The diagnosis was made in one case only where the patient had a smaller rupture of the capsule than the others who died. The patients in this report were all middle-aged multiparae who had developed toxaemia of pregnancy at about 34 weeks of pregnancy. The conclusion drawn by Mokotoff and his associates that the condition constitutes a diagnosable syndrome which should be treated by  laparotomy is agreed to with reservations. The obstetrical section of Baragwanath hospital was started in 1951, and since that time 213 719 patients have been admitted to the wards and 154 344 of these were delivered in the section. During this period, 4 patients developed a rupture of a subcapsular haematoma of the liver; an incidence of 1 in 40 000 deliveries. Of the 4 patients only 1 survived the trauma. The case histories of these patients are  presented, because they show remarkable similarities to each other and to those cases which have been reported in the literature.