Midwifery

HELLP Syndrome

Hellp-Syndrome
  • Haemolysis (H), elevated liver enzyme (EL) & low platelet count (LP) (<100000/mm3). A rare complication of pre-eclampsia. It may develop without maternal HTN.
  • It is manifested by nausea, vomiting, epigastric pain (right upper quadrant pain). Parenchymal necrosis of liver causes (SGPT & SGOT) elevation in hepatic enzymes (>70 IU/L) & bilirubin (>1.2 mg/dl)

Management

  • Principle management is same as pre-eclampsia with magnesium sulphate is started.
  • Caesarean section is a common mode of delivery.
  • Platelet transfusion can be given if count is <50,000/mm
  • When pregnancy <34 weeks, bed rest, plasma volume expansion, antithrombotic agent (dipyridamole), immunosuppressive agents (steroids).
  • The patient should be managed in an ICU until there is an improvement in platelet count, urine output, B.P, liver enzymes.

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