[Anesthesia in three women with HELLP syndrome]

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Critical Care Medicine

Background:

• HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a severe pregnancy complication with significant maternal mortality.
• Management requires early diagnosis and prompt therapy to prevent serious complications like acute renal failure, DIC, and liver rupture.

Observation:

• Three pregnant patients diagnosed with HELLP syndrome underwent emergency cesarean sections.
• Operations were performed under general anesthesia with sevoflurane due to low platelet counts, avoiding neuraxial techniques.
• Close monitoring and management of blood pressure, particularly intraoperative hypertension, were prioritized.

Findings:

• Perioperative interventions included platelet and fresh frozen plasma transfusions as needed.
• Preventive therapy for disseminated intravascular coagulation (DIC) and support for liver and renal function were administered.
• All three patients showed laboratory data recovery to near-normal ranges post-operation.

Implications:

• Successful perioperative management and recovery of patients with HELLP syndrome are achievable with careful anesthetic and critical care strategies.
• This case series highlights the importance of tailored anesthetic approaches and comprehensive supportive care in managing severe obstetric emergencies.
• Effective management can mitigate severe maternal morbidity and mortality associated with HELLP syndrome.