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[Atypical preeclampsia: case report].
Ginecologia Y Obstetricia De Mexico
|June 19, 2014
Summary
Early-onset preeclampsia (< 20 weeks gestation) is rare but possible. This case highlights atypical preeclampsia and HELLP syndrome presentation in a first-time mother, emphasizing the need for timely diagnosis.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Hypertensive Disorders of Pregnancy
Background:
- Preeclampsia before 20 weeks gestation is uncommon.
- Often associated with placental abnormalities (molar/hydropic degeneration) or antiphospholipid syndrome.
- Highlights a rare presentation in a 37-year-old nulliparous woman with chronic hypertension and infertility.
Observation:
- Patient presented at 18.5 weeks gestation with severe headache and severe hypertension (160/110 mm Hg).
- Laboratory findings included thrombocytopenia (platelets 51,000), elevated liver enzymes (AST, ALT), elevated LDH, and proteinuria (+2).
- High soluble fms-like tyrosine kinase-1/placental growth factor ratio (895.5) indicated significant placental dysfunction.
Findings:
- Diagnosis of chronic hypertension superimposed with preeclampsia and incomplete HELLP syndrome was established.
- The patient experienced rapid clinical improvement following pregnancy termination.
- Discharged on postoperative day 7 with normalized blood pressure and laboratory values.
Implications:
- Clinicians must consider preeclampsia and HELLP syndrome in early gestation (< 20 weeks).
- Prompt recognition and management are crucial for maternal outcomes in atypical presentations.
- Early diagnosis can prevent severe maternal morbidity associated with hypertensive disorders of pregnancy.
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