Peripartum Patient With Epigastric Pain

A 44-year-old woman at 36 weeks' gestation (gravida 2, primipara, and abortus 1) presented to the emergency department with epigastric pain, vomiting, and epistaxis. She was hypertensive, with blood pressure 138/90 mm Hg, and had right upper quadrant tenderness. Laboratory studies demonstrated decreased platelet levels of 122,000/μL, hemoglobin level of 11.2 g/dL, elevated transaminase levels, and proteinuria level of 13 mg/dL. Ultrasonography showed a masslike lesion in the right hepatic lobe (Figure 1), and emergency cesarean section was performed, with delivery of a healthy neonate.

http://ift.tt/2vbPzC6