Severe, Early-onset Hemolysis, Elevated Liver Enzymes, And Low Platelet (hellp) Syndrome Episode With Spontaneous Remission During Pregnancy
Merz, W. M., & Gembruch, U. (2007). Severe, early-onset hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome episode with spontaneous remission during pregnancy. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 20(8), 631–632. https://doi.org/10.1080/14767050701449810
View Original Source →Abstract
A case of a severe HELLP syndrome episode at 21 + 0 weeks of gestation is reported. Expectant management resulted in rapid improvement of all HELLP parameters. Subsequently preeclampsia developed and uteroplacental dysfunction deteriorated. Intrauterine fetal death occured at 22 + 3 weeks of gestation.
Case Details
Disease Location
Systemic (blood, spleen, kidney)
Personal Characteristics
23-year-old giip0, gestational age 21+0
Clinical Characteristics
Severe thrombocytopenia (15 g/l), markedly elevated liver enzymes, hemolysis. Patient complained of general malaise, loss of appetite, nausea and vomiting once. Diagnosis of of early-onset severe hellp syndrome. Tenth day after admission, intrauterine fetal death was diagnosed and labor induced.
Remission Characteristics
Patient was discharged the following day after labor with improving blood pressure recordings. Investigations for thrombophilia and anti-phospholipid syndrome performed six weeks after aborightion were negative.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Conservative management under close maternal monitoring. Antacid and proton pump inhibitor medication.combination drug medication (methyldopa 500 mg qid and nifedipine 10 mg bd). Complete remission of hellp syndrome parameters happened without specific therapy.