A 32-year-old woman at 30 weeks gestation with severe pre-eclampsia develops acute-onset right upper quadrant tenderness with rebound guarding. Ultrasound shows a subcapsular hematoma of the liver. Which is the most appropriate immediate management?
- A Multidisciplinary team delivery with hepatic surgery consultation ✓
- B Transfusion of fresh frozen plasma only
- C Emergency MRI for further characterization
- D Conservative management with bed rest and serial ultrasounds
Correct answer: A. Multidisciplinary team delivery with hepatic surgery consultation
Explanation
Hepatic subcapsular hematoma is a life-threatening complication of severe pre-eclampsia or HELLP syndrome. Management requires urgent delivery (the definitive treatment) combined with multidisciplinary surgical consultation for possible hepatic repair or lobectomy. Conservative management risks rupture and fatal hemorrhage. MRI delays definitive care. FFP alone does not address the underlying pathology.
Reference: High Risk Pregnancy: Management Options, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.