Abstract
Subcapsular hepatic hematoma (SHH) is a rare and life-threatening condition, often leading to severe maternal complications. Its diagnosis is frequently challenging due to nonspecific symptoms and a reliance on ultrasound findings. Case reports for this type of pregnancy complication are limited due to its low incidence. A 30-year-old pregnant woman at 32.3 weeks with preeclampsia with severe features presented with epigastric pain and high blood pressure, requiring an emergency C-section. She developed a peri-hepatic subcapsular hematoma, leading to hypovolemic shock and multiple surgeries, including liver packing. After stabilization and follow-up, she was discharged without complications. We reported a rare case of a patient with hepatic subcapsular hematoma secondary to preeclampsia with severe features. SHH is a rare but serious pregnancy complication, often linked to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and preeclampsia, with a high maternal mortality rate. Diagnosis is challenging due to nonspecific symptoms, requiring imaging studies such as ultrasound or CT. Treatment varies from conservative management to surgical intervention, depending on hemodynamic stability.