{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T03:05:46Z","timestamp":1772852746972,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>HELLP syndrome is a severe complication of hypertensive disorders in pregnancy, characterized by hemolysis, elevated liver enzymes, and thrombocytopenia. Severe cases can lead to various complications such as DIC and placental abruption, directly endangering the lives of both the mother and the fetus. Among these, intra-abdominal hemorrhage caused by the rupture of a subcapsular hepatic hematoma is particularly dangerous. Traditionally, the rescue of liver rupture relies on emergency laparotomy. In recent years, the development of interventional radiology has provided a minimally invasive option of transcatheter arterial embolization (TAE) for hemodynamically stable patients. TAE has significant advantages in emergency hemostasis of HELLP-related liver rupture and can reduce maternal and fetal mortality. This case report analyzes a case of preeclampsia complicated with inevitable abortion progressing to HELLP syndrome with liver rupture and hemorrhage. After successful hemostasis with TAE, the patient received comprehensive intensive care including plasma exchange, blood transfusion, and continuous renal replacement therapy. The case emphasizes that early identification, multidisciplinary collaboration, accurate imaging evaluation, TAE for minimally invasive hemostasis, close renal support, and long-term follow-up are the keys to reducing the mortality of HELLP syndrome-related liver rupture and preventing recurrence in future pregnancies.<\/jats:p>","DOI":"10.3389\/fmed.2025.1672137","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:25:39Z","timestamp":1762323939000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Case analysis and literature review of preeclampsia complicated by inevitable abortion progressing to HELLP syndrome with liver rupture and hemorrhage"],"prefix":"10.3389","volume":"12","author":[{"given":"Guangyang","family":"Xing","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yani","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e237","DOI":"10.1097\/AOG.0000000000003891","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1126\/science.1111726","article-title":"Latest advances in understanding preeclampsia","volume":"308","author":"Redman","year":"2005","journal-title":"Science."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1002\/ajh.26328","article-title":"Severe thrombocytopenia and microangiopathic hemolytic anemia in pregnancy: A guide for the consulting hematologist","volume":"96","author":"J Perez Botero","year":"2021","journal-title":"Am J Hematol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1111\/1471-0528.16225","article-title":"Maternal risk factors and adverse birth outcomes associated with HELLP syndrome: a population-based study","volume":"127","author":"Lisonkova","year":"2020","journal-title":"BJOG"},{"key":"B5","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.preghy.2022.08.005","article-title":"Intensive care patients with preeclampsia - Clinical risk factors and biomarkers for oxidative stress and angiogenic imbalance as discriminators for severe disease","volume":"30","author":"Edvinsson","year":"2022","journal-title":"Pregnancy Hypertens."},{"key":"B6","doi-asserted-by":"publisher","first-page":"907","DOI":"10.3760\/cma.j.cn112141-20220707-00444","article-title":"Comparison of clinical features in antepartum and postpartum HELLP syndrome","volume":"57","author":"Li","year":"2022","journal-title":"Zhonghua Fu Chan Ke Za Zhi."},{"key":"B7","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/j.tjog.2020.07.003","article-title":"Hepatic rupture in preeclampsia and HELLP syndrome: a catastrophic presentation","volume":"59","author":"Dubey","year":"2020","journal-title":"Taiwan J Obstet Gynecol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.ejogrb.2012.09.026","article-title":"Pathogenesis of the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP): a review","volume":"166","author":"Abildgaard","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1080\/14767058.2020.1754790","article-title":"Comparing acute fatty liver of pregnancy from hemolysis, elevated liver enzymes, and low platelets syndrome","volume":"35","author":"Byrne","year":"2022","journal-title":"J Matern Fetal Neonatal Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/j.1365-2141.2012.09167.x","article-title":"Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies","volume":"158","author":"Scully","year":"2012","journal-title":"Br J Haematol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"3386","DOI":"10.3390\/cells10123386","article-title":"Platelet activation mechanisms and consequences of immune thrombocytopenia","volume":"10","author":"Sun","year":"2021","journal-title":"Cells."},{"key":"B12","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00404-008-0829-7","article-title":"Postpartum spontaneous rupture of a liver hematoma associated with preeclampsia and HELLP syndrome","volume":"279","author":"Miguelote","year":"2009","journal-title":"Arch Gynecol Obstet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1097\/GRF.0000000000000253","article-title":"Diagnosis and management of HELLP syndrome complicated by liver hematoma","volume":"60","author":"Ditisheim","year":"2017","journal-title":"Clin Obstet Gynecol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"110291","DOI":"10.1016\/j.ijscr.2024.110291","article-title":"Transcatheter arterial embolization in postpartum HELLP syndrome: a case report","volume":"123","author":"Zhou","year":"2024","journal-title":"Int J Surg Case Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"8895319","DOI":"10.1155\/2021\/8895319","article-title":"HELLP! the novel use of continuous renal replacement therapy and nitric oxide in the treatment of acute respiratory failure in HELLP syndrome","volume":"2021","author":"Azimi-Ghomi","year":"2021","journal-title":"Case Rep Crit Care."},{"key":"B16","doi-asserted-by":"publisher","first-page":"3777","DOI":"10.12659\/MSM.895220","article-title":"Corticosteroid therapy for management of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome: a meta-analysis","volume":"21","author":"Mao","year":"2015","journal-title":"Med Sci Monit."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1672137\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:25:47Z","timestamp":1762323947000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1672137\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":16,"alternative-id":["10.3389\/fmed.2025.1672137"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1672137","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"article-number":"1672137"}}