HELLP syndrome: a case report with guidelines for diagnosis and management

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Critical Care Medicine

Background:

• HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) is a severe pregnancy complication.
• Twin pregnancies present unique challenges in obstetric management.
• Urgent delivery is often necessary for HELLP syndrome, especially in preterm gestations.

Observation:

• A 25-year-old patient at 34 weeks gestation with twin pregnancy developed HELLP syndrome.
• The patient required urgent Caesarean section.
• Preoperative interventions included central venous and urinary catheterization, fresh frozen plasma, and platelet transfusion.

Findings:

• The patient's critical preoperative condition necessitated extensive preparation.
• Invasive monitoring was crucial for successful management.
• Anesthetic choices were dictated by liver/renal dysfunction and severe thrombocytopenia.

Implications:

• This case underscores the importance of meticulous preoperative assessment and intervention in patients with HELLP syndrome.
• Multidisciplinary care involving obstetrics, anesthesia, and critical care is vital.
• Careful anesthetic planning is essential to mitigate risks associated with organ dysfunction and coagulopathy.