HEPATIC RUPTURE IN PREGNANCY-ASSOCIATED WITH COCAINE USE

Background: Hepatic rupture during pregnancy has a high rate of matern al and fetal mortality. Most cases occur as a complication of severe p regnancy-induced hypertension, and maternal survival has been highest in patients managed with conservative surgical therapy. Case: A woman in late pregnancy experienced hepatic rupture associated with cocaine use. She underwent emergency cesarean delivery and was treated with to pical hemostatic agents, perihepatic packing, and hepatic artery embol ization. Reexploration with perihepatic packing was performed three ti mes during the first 48 hours after delivery to control hepatic hemorr hage. Vasopressor support, blood product replacement, and prolonged as sisted ventilation were used, and the patient was discharged on hospit al day 42. Conclusion: Liver damage may result from the potent vasocon strictor property of cocaine, leading to vasospasm and ischemia. Conse rvative surgical management of hepatic rupture and supportive measures resulted in maternal survival.