Postpartum HELLP syndrome after a normotensive pregnancy

Severe pre-eclampsia, associated with HELLP syndrome, can occur after a normal delivery and birth in a woman whose blood pressure has remained normal throughout the antenatal period. Although rare, the syndrome can lead to pulmonary oedema or renal failure, and should be borne in mind when a woman develops epigastric or right upper-quadrant pain after a normal pregnancy and delivery. A significant fall in the platelet count in the antenatal period may be a useful indicator of risk.