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[HELLP syndrome--postpartum].

K Bischofberger1, S Diehl

  • 1Evangelisches Krankenhaus Düsseldorf.

Geburtshilfe Und Frauenheilkunde
|September 1, 1991
PubMed
Summary
This summary is machine-generated.

HELLP syndrome can develop post-delivery without prior severe hypertension or proteinuria. Postpartum screening is crucial for epigastric pain to detect this life-threatening condition.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Nephrology

Background:

  • A 35-year-old woman, gravida II, para II, with a history of Cesarean section for breech presentation, presented at 40 weeks gestation with hypertension and proteinuria.
  • Her blood pressure was managed within the high-normal range (140/90 mmHg) with Dihydralazine (50 mg/day).

Observation:

  • Following labor induction with prostaglandin (PGE2) and a normal delivery, a curettage was performed due to retained placental tissue.
  • Two hours postpartum, the patient experienced sudden epigastric pain, nausea, and vomiting.

Findings:

  • Blood chemistry revealed the rapid development of severe postpartum HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) complicated by acute renal failure.
  • This case highlights that severe HELLP syndrome can manifest without pre-existing severe hypertension or proteinuria.

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Implications:

  • Mandatory postpartum blood chemistry screening is recommended for patients presenting with severe epigastric or right upper quadrant pain.
  • Early detection and management of HELLP syndrome are critical for preventing potentially fatal maternal complications.