HELLP Syndrome: A Rare but Critical Obstetric Conundrum
Published: 2023-10-26
Page: 172-178
Issue: 2023 - Volume 6 [Issue 1]
Madhuri Akasapu
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Sri Satya Manogna Naidu Vanarasi
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Pavan Kumar Yanamadala *
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Rupa Lavanya Gogulamanda
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Thanmayi Sai Lakshmi Thota
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Nandini Palivela
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
Bhagya Aruna Chikkala
Department of Pharmacy Practice, Aditya Pharmacy College, Surampalem-533437, India.
*Author to whom correspondence should be addressed.
Abstract
Background: HELLP Syndrome is one of the significant difficulties of pregnancy and the acronym represents H=Hemolysis, EL=Elevated Liver Enzymes, LP=Low Platelets. It is a significant and hazardous type of toxemia, which is a condition where a pregnant lady has hypertension that harms the Liver and Kidney. It typically develops between the 26th to 40th long stretches of Fetal Development, and at times in the week after the child is conceived. Eclampsia is the most extreme type of toxemia joined by seizures. The rate is 0.5-0.9% in most pregnant ladies, however, in extreme Toxemia, 10-20% of cases have been accounted for.
Case Subtleties: A 29-year-old Multigravida lady who was pregnant for the third time, at 35 weeks of pregnancy was presented with the objections of serious stomach torment for one day, and fetal development was not evaluated. She had a known instance of hypertension during her past pregnancy and was dealt with apparently with Labetalol, furthermore gone through a lower Cesarean segment two years earlier. She was given Magnesium Sulfate 4g IV over 5 Minutes.
Discussion: Blood products like platelets, red blood cells, and fresh frozen plasma ought to be transferred. On account of early pregnancy, corticosteroids can be utilized to invigorate the development of fetal lungs. Basic follow-up is expected for patients with HELLP Syndrome.
Conclusion: Early location and treatment of HELLP syndrome, either by inception or by typical work or by cesarean area is valuable for both mother and embryo and forestalls further confusions.
Keywords: HELLP, hypertension, serum glutamic-oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase, hemoglobin
How to Cite
References
Chawla Sushil, Marwaha Ashish, Agarwal Raju. HELLP or help: A Real Challenge Journal of Obstetrics and Gynecology of India (May-June 2015) 65(3):172-175 DOI 10.1007/s13224-014-0482-8.
Aesha A. Patel, Tushar M. Shah. A Case report of HELLP syndrome, IAIM. 2015;2(1):108-111.
Nidhi O. Bang, Meena N. Satia, Supriya Poonia. Obstetric and neonatal outcome in pregnancies complicated by hemolysis elevated liver enzymes low platelet count syndrome at a tertiary care center in India, Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2407-2412.
Ashwini Mallesara, Srushti R. Kanta, Prashanth Shivappa, A clinical study of HELLP syndrome and its outcome in a tertiary health care system, Int J Reprod Contracept Obstet Gynecol. 2016;5(12): 4196-4199.
Lachmeijer AM, Arngrı ́msson R, Bastiaans EJ. A genome-wide scan for preeclampsia in the Netherlands. Eur J Hum Genet. 2001;9:758.
Abildgaard U, Heimdal K. Pathogenesis of the syndrome of hemolysis, elevated liver enzymes, and low platelet count(HELLP): a review. Eur J Obstet Gynecol Reprod Biol. 2013;166:17.
Michael Geary. The HELLP syndrome, British Journal of Obstetrics and Gynaecology. 1997; 104:887 – 891.
Kestutis Rimaitis, Lina Grauslyte, Asta Zavackiene, Vilda Baliuliene, Ruta Nadisauskiene, Andrius Macas. Diagnosis of HELLP syndrome: A 10-year survey in a perinatology centre, Int. J. Environ. Res. Public Health. 2019;16:109.
Douglas M Woudstra, Sue Chandra, G Justus Hofmeyr, and Therese Dowswell. Corticosteroids for HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in pregnancy, CDSR. 2010;9.
Audibert F, Friedman SA, Frangieh AY, Sibai BM. Clinical utility of strict diagnostic criteria for the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynecol. 1996; 175:460–464?
DOI: 10.1016/S0002-9378(96)70162-X.
Martin JN, Jr, Rose CH, Briery CM. Understanding and managing HELLP syndrome: The integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol. 2006;195:914–934?
DOI: 10.1016/j.ajog.2005.08.044.
Sibai BM. The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol. 1990; 162:311–316?
Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clin Perinatal. 2004;31:807–33.
DOI: 10.1016/j.clp.2004.06.008.
William M. Curtin, Louis Weinstein. A review of HELLP syndrome. Journal of Perinatology, 1999;19(2):138–143.
Eklof B, Gjores JE, Lohi A, Staszkiewicz W, Norgren L. Spontaneous rupture of liver and spleen with severe intra-abdominal bleeding during streptokinase treatment of deep venous thrombosis. Vasa. 1977;6:369-71.
Taccone FS, Starc JM, Sculier JP. Splenic spontaneous rupture (SSR) and hemoperitoneum associated with low molecular weight heparin: A case report. Support Care Cancer 2003;11:336-8.
Arnulf G, Chacomac R, Morel JP. Hémorragie gravissime par rupture d’hématome souscapsulaire rate saine au cours d’héparinisation pour désoblitération artérielle. Lyon Chirurgical. 1968;64: 961-4.
Weiss SJ, Smith T, Laurin E, Wisner DH. Spontaneous splenic rupture due to subcutaneous heparin therapy. J Emerg Med. 2000;18:421-6.
Stella CL, Sibai BM. Preeclampsia: Diagnosis and management of the atypical presentation. J Matern Fetal Neonatal Med 2006;19:381-6.
Petca A, Miron BC, Pacu I, Dumitrașcu MC, Mehedințu C, Șandru F, Petca RC, Rotar IC. HELLP syndrome—holistic insight into pathophysiology. Medicina. 2022;58(2):326.
Bazzan M, Todros T, Tedeschi S, Ardissino G, Cardaropoli S, Stella S, Montaruli B, Marchese C, Roccatello D, Cugno M. Genetic and molecular evidence for complement dysregulation in patients with HELLP syndrome. Thrombosis Research. 2020;196:167-74.