A Rare Case in 17 Weeks of Gestation: Hemolysis, Elevated Liver Enzymes and Low Platelet Count Syndrome

Abstract

The HELLP syndrome is a condition characterized by Hemolysis, Elevated Liver enzymes and Low Platelet numbers. It occurs in 0.5-0.9% of all pregnancies and 10-20% of patients with severe preeclampsia. It often occurs as part of severe preeclampsia after 27th week of gestation. We hereby present an unusual case of HELLP syndrome, which was diagnosed at 17 weeks of gestation. If definitive diagnosis of HELLP syndrome is made, prompt termination of pregnancy should be considered, particularly in pregnancies, which are remote from term, to prevent potentially fatal complications both for the mother and the fetus.

Keywords

• HELLP syndrome
• early pregnancy
• Pre-eclampsia

17. gebelik haftasında nadir bir vaka: Hemoliz, yükselmiş karaciğer enzimleri, düşük platelet sayısı sendromu

Abstract

HELLP (Haemolysis, Elevated Liver enzymes and Low Platelet) sendromu hemoliz, yükselmiş karaciğer enzimleri ve düşük platelet sayısı ile karakterize bir sendromdur. Tüm gebelerin %0.5-0.9'unda ve şiddetli preeklampsili gebelerin %10-20'sinde görülür. Hellp sendromu genellikle 27. gebelik haftasından sonra görülen bir durumdur. Biz burada 17 haftalık gebede görülen bir Hellp sendromu vakasını sunduk. Özellikle termden uzak gebeliklerde Hellp sendromundan kesin emin olunursa ileriki zamanlarda gelişebilecek anne ve bebeğin hayatını riske edebilecek komplikasyonları önlemek için gebelik hızla sonlandırılmalıdır.

Keywords

• HELLP sendromu
• erken gebelik
• preeklampsi

References

1. Stone JH. HELLP syndrome: hemolysis elevated liver enzymes, and low platelets. JAMA 1998; 280:559-561.
2. Kirkpatrick CA. The HELLP syndrome, Review. ActaClin Belg. 2010;65:91-97.
3. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) Am J Obstet Gynecol. 1993;169:1000–1006.
4. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–991.
5. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Pregnancy Hypertension: Cunningıham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23 rd edn. Texas: McıGraw Hill, 2010:p.774-794.
6. Sibai BM, Taslimi M, Abdella TN, Brooks TF, Spinnato JA, Anderson GD. Maternal and perinatal outcome of conservative management of severe preeclampsia in midtrimester. Am J Obstet Gynecol. 1985;152:32-37.
7. WHO/RHR. Safe abortion: technical and policy guidance for health systems (2nd edition), 2012
8. Vigil-De Gracia P. Acute fatty liver and HELLP