Hepatic capsule haemorrhage due to HELLP syndrome managed with recombinant factor VIIa

HELLP syndrome is a serious complication of pre-eclampsia and is associated with increased maternal and foetal mortality. HELLP syndrome is characterised by haemolysis, elevated liver enzymes and low platelets. Cardiorespiratory compromise may require intensive care management. Changes in haematological state may occur rapidly, resulting in coagulopathy and haemorrhage necessitating aggressive management in conjunction with haematologists. We describe the successful management of massive intra-abdominal haemorrhage due to capsular tear of the liver with recombinant factor VIIa (rFVIIa) following surgery in a patient with pre-eclampsia and HELLP.