This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Pregnancy induced Hypeension, Subject name: Gynaecology & Obstetrics
A pregnant woman admitted with pre eclampsia complicated with HELLP syndrome. She suddenly developed hypotension, breathlessness and right hypochondriac pain. USG showed hemoperitoneum. Most probable diagnosis is? 
Select and explain. 
A. Abruptio placentae, B. DIC, C. Rupture of hepatic hematoma, D. Pa of pre-eclamptic toxemia
C: Rupture of hepatic hematoma
Answer: C: Rupture of hepatic hematoma 
Explanation: Peripoal hemorrhagic necrosis (characteristic hepatic lesion in pre eclampsia)in the liver periphery with some degree of hepatic infarction accompanied with hemorrhage Clinical presentation: moderate to severe right-upper quadrant or midepigastric pain hepatic region tenderness. raised liver enzymes, hemolysis and thrombocytopenia( HELLP Syndrome) hemorrhagic infarct may form a subcapsular hematoma which may rupture leading to sudden hypotension, breathlessness, hemoperitoneum.