PATHOMORPHOLOGY OF THE LIVER IN DECEASED PATIENTS IN THE EARLY PERIOD OF POSTPARTUM OBSTETRIC HEMORRHAGE

Abstract

In the early period of postpartum obstetric hemorrhage (mainly within 2–6 hours), acute hemodilution and hypovolemia lead to massive anemia in the liver tissue, resulting in the development of "shock liver." This involves altered histotectonics of hepatic lobules, isolated hepatocytes, hyaline thrombi in hemocapillaries, and focal sludging phenomenon in erythrocytes. A characteristic feature is the scarcity of necrotic foci alongside massive hyaline droplet and hydropic dystrophy of hepatocytes. This is driven by an intracellular protein-energy deficit caused by a sharp decrease in blood protein levels and the massive release of proteins from hepatocyte cytoplasm into the vascular lumen.