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Severe HELLP syndrome remote from term
F Gardeil1, G Gaffney, J J Morrison
1Department of Obstetrics & Gynaecology, University College Hospital Galway. bgardeil@esatclear.ie
A 27 year-old nulliparous woman was admitted to University College Hospital Galway with severe preeclampsia at 21 weeks 'gestation. In addition, there was evidence of HELLP syndrome with renal failure. A decision was made to end the pregnancy to save the mother's life. Labour was induced with misoprostol and vaginal delivery of a male stillborn fetus weighing 250 g was achieved after 19 hours. The condition of the patient improved gradually following delivery. Renal impairment, however, persisted postpartum. HELLP syndrome is a life-threatening complication of pregnancy which can only be cured by delivery. Other therapeutic modalities are only palliative but may improve the outcome for the very premature viable fetus. Conservative management is not an option when HELLP syndrome occurs long before fetal viability has been reached.
A 27 year-old nulliparous woman was admitted to University College Hospital Galway with severe preeclampsia at 21 weeks 'gestation. In addition, there was evidence of HELLP syndrome with renal failure. A decision was made to end the pregnancy to save the mother's life. Labour was induced with misoprostol and vaginal delivery of a male stillborn fetus weighing 250 g was achieved after 19 hours. The condition of the patient improved gradually following delivery. Renal impairment, however, persisted postpartum. HELLP syndrome is a life-threatening complication of pregnancy which can only be cured by delivery. Other therapeutic modalities are only palliative but may improve the outcome for the very premature viable fetus. Conservative management is not an option when HELLP syndrome occurs long before fetal viability has been reached.