[Anesthesia in three women with HELLP syndrome]

Three pregnant women with diagnosis of HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), received emergency cesarean section in our hospital. Considering low platelet counts, in all three patients, operations were performed under general anesthesia using sevoflurane without epidural or spinal anesthesia. Special attention was paid to management of blood pressure, especially intra-operative hypertension. Moreover, if necessary, platelet and fresh frozen plasma were transfused, and therapy to prevent disseminated intravascular coagulation (DIC) and to protect liver and renal function, was performed perioperatively. As a result, laboratory data of all three patients recovered to almost within normal ranges after operation, and they were discharged without untoward complications. HELLP syndrome is a severe complication of pregnancy. Complications of this syndrome were severe including acute renal failure, DIC, pulmonary edema, cerebral hemorrhage and liver rupture. It is reported that maternal mortality is 2-24%. In the management of pregnant women complicated with HELLP syndrome, early diagnosis and adequate therapy, including preventive therapy for complications, are necessary.