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HELLP Syndrome A Therapeutic Challenge Case Report With Review of Literature
HELLP Syndrome A Therapeutic Challenge Case Report With Review of Literature
National Journal of Medical and Dental Research, April-June 2013: Volume-1, Issue-3, Page 62-65
No.
Abstract:
HELLP Syndrome is a life threatening obstetric emergency usually considered to be
a variant or complication of pre eclampsia. Both conditions usually occur during the
later stages of pregnancy or sometimes after child birth. We are here, reporting a
case of 25 year old woman who presented with classical HELLP syndrome in which
prompt diagnosis and appropriate anesthetic management helped us to reduce
morbidity and mortality related with HELLP syndrome. The policy that prevention
is far more important than cure coupled with proper pre anesthetic evaluation will
help to reduce the incidence of anesthetic complications arising during .regional
anesthesia. The role of regional anesthesia in management of HELLP syndrome is
reviewed.
Keywords: HELLP Syndrome, Spinal Anesthesia, Platelet Count
Natl J Med Dent Res 2013; 1(3) : 62-65
Case Report:
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National Journal of Medical and Dental Research, April-June 2013: Volume-1, Issue-3, Page 62-65
Discussion:
HELLP syndrome is a life threatening obstetric
complication usually associated with pre eclampsia. Its
incidence is 0.5% to 0.9% of all pregnancies. It is related
with severe pre eclampsia (10% to 20%). Both conditions
occur after twenty weeks of gestation and may occur after
5 to 12 weeks of childbirth. HELLP is acronym for; H
haemolysis, EL -elevated liver enzymes, LP - low platelets.
The term HELLP syndrome was first used by Louis
Weinstein in 1982 [1]. Although the same clinical features
and investigations were noticed in 1954 by Pritchard [2].
The onset was gradual. Clinical features include severe
headache (30%), malaise (90%); nausea, vomiting (30%);
band pain around upper abdomen (65%), and edema.
Disseminated intravascular
coagulation is also seen
in about 20%of all women with HELLP syndrome [3].
However, the path physiology is dynamic .Preeclampsia
is a common and severe disease in pregnancy, a major
Table: 1
Mild
Moderate
Severe
Platelet count
150000to 100000
100000,>50,000
<50000
AST/ALT
>40 IU
>70IU/L
>70 IU
LDH
>600IU/L
>600IU/L
>600IU/L
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National Journal of Medical and Dental Research, April-June 2013: Volume-1, Issue-3, Page 62-65
Conclusion:
Spinal anesthesia can be given safely in HELLP syndrome
with platelet count up to 60,000/ml as platelet functions are
not impaired and spinal anaesthesia, per say is otherwise
safer and cost effective than general anaesthesia.
References:
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National Journal of Medical and Dental Research, April-June 2013: Volume-1, Issue-3, Page 62-65
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