Imitators of severe preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Critical Care Medicine

Background:

• Several obstetric, medical, and surgical disorders mimic severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.
• These conditions are life-threatening emergencies during pregnancy or postpartum, associated with high maternal mortality and long-term sequelae.
• Pathophysiologic abnormalities often include thrombotic microangiopathy, thrombocytopenia, and hemolytic anemia.

Purpose of the Study:

• To review the diagnosis, management, and counseling of pregnant and postpartum women with conditions imitating severe preeclampsia-HELLP syndrome.
• To differentiate these rare but serious conditions from severe preeclampsia-HELLP syndrome based on current literature.

Main Methods:

• Review of case reports and case series due to the rarity of these conditions.
• Focus on differential diagnosis, management strategies, and counseling based on recent studies.

Main Results:

• Differential diagnosis is challenging due to overlapping clinical and laboratory findings.
• Management varies significantly; delivery is indicated for severe preeclampsia and acute fatty liver of pregnancy, while pregnancy may continue in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome and systemic lupus erythematosus exacerbations.

Conclusions:

• Accurate diagnosis of preeclampsia mimics is critical for appropriate management and improved maternal and perinatal outcomes.
• Clinicians must be aware of these rare conditions and their distinct treatment protocols.