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[A delay in the HELLP syndrome diagnosis]
J Záhumenský1, E Menzlová, H Hermann
1Gynekologicko-porodnická klinika 1. Iékarské fakulty UK a FN Na Bulovce Praha. jozef.zahumensky@gmail.com
Insights
HELLP syndrome, a serious pregnancy complication, involves hemolysis, elevated liver enzymes, and low platelets. Early diagnosis and delivery are crucial for maternal and fetal survival.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Hematology
Background:
- HELLP syndrome is a severe obstetric complication affecting approximately 0.6% of pregnancies, typically in the second half.
- It is characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets.
- The condition can manifest with or without preeclampsia.
Observation:
- HELLP syndrome presents with specific laboratory abnormalities that can mimic other liver or gallbladder diseases.
- Physiological changes during pregnancy can predispose women to conditions with overlapping symptoms.
- Symptoms may lead women to seek care from non-obstetrician physicians.
Findings:
- The syndrome's pathogenesis remains incompletely understood.
- Potential severe complications include disseminated intravascular coagulation, liver rupture, and multi-organ failure.
- Delivery at the earliest feasible term is the primary management strategy.
Implications:
- Timely diagnosis is critical to prevent life-threatening outcomes for both mother and child.
- Increased awareness among healthcare providers is necessary for prompt referral to obstetrical care.
- Further research into HELLP syndrome pathogenesis could lead to improved diagnostic and therapeutic approaches.
Abstract:
HELLP syndrome is a serious obstetrical complication that tends to occur in the second half of pregnancy that complicates six promiles of pregnancies. The term HELLP syndrome is derived from the beginning letters of the English words indicating laboratory changes, which is occurs as a specific illness in pregnancy. There is hemolysis, elevated liver enzymes and a decreased platelet count. It can present itself with preeclampsia or without it. The most serious complications are disseminated intravascular coagulation, liver rupture or various organ failures. The pathogenesis at the moment is not completely known. The basic approach to care is delivery at the earliest possible term. HELLP syndrome generally arises in the second or third trimester of pregnancy, but can also occur after delivery. It has typical signs, which can also arise due to other liver diseases, but more frequently in diseases of the gall bladder, which in pregnancy given the physiological changes in the body of the pregnant women is also predisposed. In this context, woman with this problem can seek out other physicians than obstetricians. In our case, we wanted to refer to the needs of early diagnosis of this frequently diagnosed illness, since in the case of late diagnosis and a woman not sent to the obstetrical department can lead to a serious life threatening state for the mother and child.
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