[Anesthetic management of a patient with HELLP syndrome with bronchial asthma]

We gave anesthesia for cesarean section to 30 year-old female with HELLP syndrome with bronchial asthma. HELLP syndrome is characterized by hemolysis, liver dysfunction and thrombocytopenia, besides syndrome of severe toxemia of pregnancy. After intubation with sevoflurane, diazepam and vecuronium, anesthesia was maintained with nitrous oxide, oxygen, sevoflurane and vecuronium, because she had an attack of bronchial asthma before operation. Though she had no eclampsia nor hypertension during operation, her babies were intubated and were cared in pediatric ward. Though she had improvements of liver dysfunction and thrombocytopenia after operation, it took 2 days to extubated, because she had frequent attacks of bronchial asthma. We conclude that we should perform cesarean section for a patient with HELLP syndrome as soon as possible.