A pregnant woman with HELLP syndrome suddenly developed hypotension, right hypochondriac pain, ascites, pleural effusion and sudden onset of breathlessness. What is your diagnosis?

Hepatic hematoma can develop in the absence of under lying pathology . the majority of cases in pregnancy occur in the presence of HELLP. HELLP syndrome associated with maternal morbidity including acute renal failure, hepatic hematoma, pulmonary edema, cerebral hemorrhage and DIC, subsequent pregnancies are infrequently complicated by HELLP. Unruptured hepatic hematoma are probably more common than clinically suspected and are more likely to be found with HELLP syndrome. The current management of hematoma usually consists of observation unless bleeding is ongoing.in rare cases liver transplantation is necessary.