Saved by the Massive Transfusion Protocol: A Case Report of an Obstetric Patient With Hemolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome and Glisson Capsule Rupture

A 31-year-old primigravid parturient with no pertinent medical history was admitted at 40 weeks and 4 days of gestation for postdate induction of labor. She was subsequently diagnosed with preeclampsia and developed hemolysis, elevated liver enzymes, and a low platelet count. An emergency cesarean delivery ensued owing to fetal bradycardia. Massive hemorrhage occurred on incision, and a diagnosis of ruptured subcapsular hepatic hematoma was made. The hemorrhage was managed using our institution's massive transfusion protocol. Early transfusions and mobilization of necessary support stipulated in this protocol led to full recovery of the patient, with no significant morbidity.