Poster Session 4
Uri Amikam, MD, MHA (he/him/his)
MFM Specialist
Lis Maternity & Women's Hospital
Ramat-Hasharon, HaMerkaz, Israel
Ahmad badeghiesh, MD, MPH
Department of Obstetrics and Gynecology, King Abdulaziz University, Rabigh Branch
Rabigh, Makkah, Saudi Arabia
Haitham Baghlaf, MD, MPH
Assistant professor
Department of Obstetrics and Gynecology, University of Tabuk, Tabuk, Saudi Arabia, Tabuk, Saudi Arabia
Michael H. Dahan, MD
McGill University
Montreal, Quebec, Canada
Richard Brown, MD
Maternal Fetal Medicine Specialist
McGill University
Montreal, Quebec, Canada
Subcapsular Liver Hematoma (SLH) is a rare life-threatening complication of preeclampsia and the data regarding it is scarce. We aimed to compare pregnancy and perinatal outcomes in women with preeclampsia with and without an SLH.
Study Design: We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Included in the study were all pregnant women who delivered or had a maternal death in the US between 2004-2014 with an ICD-9 diagnosis of preeclampsia. We divided the cohort into women with a diagnosis of SLH (study group) and women without an SLH (control group). Pregnancy and perinatal outcomes were compared between the two groups using multivariate logistic regression models adjusting for potential confounders.
Results: Overall, 327,485 women met the inclusion criteria. Amongst them, 119 women had a diagnosis of SLH. Women with an SLH, compared to those without, were more likely to be older (p=0.002); had a higher BMI (BMI >30kg/m2) (p=0.004); and suffered from chronic hypertension (p=0.007). Patients in the SLH group, compared to those without, had a higher rate of eclampsia (aOR 15.23, 95% CI 4.82-48.16, p< 0.001); and placental abruption (aOR 8.87, 95% CI 5.62-14.01, p< 0.001). Additionally, they had a higher rate of cesarean delivery (aOR 3.02, 95% CI 1.95-4.68, p< 0.001), postpartum hemorrhage (aOR 3.5, 95% CI 2.24-5.48, p< 0.001), packed red blood cell transfusion (aOR 23.58, 95% CI 16.41-33.89), disseminated intravascular coagulation (DIC) (aOR 23.11, 95% CI 14.67-36.41, p< 0.001), and maternal death (aOR 98.48, 95% CI 36.4-266.45, p< 0.001). Regarding neonatal outcomes, patients with an SLH, compared to those without, had a higher rate of intrauterine fetal demise (IUFD) (aOR 30.69, 95% CI 19.36-48.67, p< 0.001).
Conclusion: Women diagnosed with an SLH had a higher incidence of myriad pregnancy and perinatal complications, including DIC, maternal death, and IUFD, as compared to women with preeclampsia alone, highlighting the severity of this condition.
