[Diagnostic and therapeutic problems in HELLP syndrome].

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Critical Care Medicine

Context:

• HELLP syndrome is a severe, life-threatening complication of preeclampsia.
• Despite increased awareness, maternal and perinatal mortality rates remain high.
• Diagnostic challenges include early detection, differential diagnosis, and varying definitions.

Purpose:

• To highlight diagnostic difficulties in HELLP syndrome.
• To recommend laboratory screening for early hemolysis detection.
• To emphasize the necessity of prompt delivery for definitive management.

Summary:

• Early hemolysis detection via serum haptoglobin is recommended.
• Disseminated intravascular coagulation (DIG) is secondary; heparin and antithrombin III are contraindicated.
• While conservative measures may stabilize patients, termination of pregnancy is the only definitive cure.

Impact:

• Improved early detection of hemolysis through serum haptoglobin.
• Avoidance of potentially harmful treatments like heparin for secondary DIG.
• Recommendation for immediate delivery, often via C-section, improves perinatal outcomes.