Wound haematoma: The first sign in a case of late postpartum
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HELLP syndrome, a severe manifestation of preeclampsia characterised by haemolysis, elevated liver enzymes, and thrombocytopaenia, occurs in 0.5–0.9% of pregnancies and is associated with significant maternal and fetal morbidity and mortality. We present the case of a 30 year old primigravida (RL) who developed a wound haematoma nearly 72 h after an emergency caesarean section for failure to progress, with no prior hypertension or proteinuria documented. Although RL remained completely asymptomatic, investigations for delayed bleeding revealed severe class I HELLP syndrome with a platelet count of < 50,000 ?L, significant haemolysis, acute renal failure, fulminant hepatic failure and significant autoanticoagulation. Paracetamol had been administered for post-operative analgesia and a paracetamol level was in the toxic level....

http://www.sciencedirect.com/science/article/pii/S2214911215300047
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