[HELLP syndrome. Critical state. Current concepts]

The HELLP syndrome is an English acronym, for describing patients with Pregnancy Induced Hypertension (PIH), who also has hemolysis, elevated hepatic enzymes and low platelets, its presence is associated with a frequency of maternal mortality from 5 to 25% and when it is associated with hepatic rupture it increases to 35% and a perinatal one from 30 to 60%. It is present in 2 to 12% among women with PIH. Its etiology has not been elucidated completely, the base of its pathophysiology is an unbalance in prostanoid metabolism which conduces to generalize vasopasm with the subsequent endothelial damage and platelets activation. Sibaí describes the diagnostic parameters of the syndrome. Its initial treatment is the hemodinamic stabilization of the maternal status and the evaluation of fetal well-being for decide whether immediate delivery is indicated. HELLP appears in the puerperium in 30% of the cases. There are both maternal and perinatal severe complications, and a recurrence risk of a 4 to 27%. We emphasize the importance of early detection of the syndrome which improves maternal-fetal prognosis.