Spontaneous hepatic hemorrhage during pregnancy.

Spontaneous rupture of the liver during pregnancy seems to represent an extreme vascular complication of toxemia. The very high mortality rate has generally been attributable to uncontrolled hemorrhage. However, control of the hemorrhage may not be sufficient to achieve recovery. Hepatic dysfunction may proceed to necrosis associated with multiple organ failure, even after successful hemostasis. Although ligation of the hepatic artery has been successful in controlling hemorrhage in hepatic trauma, this maneuver may contribute to injury in patients with this lesion in whom there is a preexisting hepatic abnormality. In this brief review, the relationship of the underlying pathology to a variety of therapeutic measures in the context of a catastrophic complication of pregnancy are discussed.