HELLP Syndrome

If unrecognized, preeclampsia can progress to a syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). This is another complication in seemingly stable patients. The HELLP syndrome is noted in 5% to 10% of patients with preeclamptic symptoms. Such patients often present with RUQ and epigastric pain and a peripheral blood smear consistent with a microangiopathic hemolytic anemia. There may be decrements in the platelet count and increments in the transaminase (AST, ALT) and lactic acid dehydrogenase (LDH) enzymes. This is a life-threatening emergency that requires prompt delivery of the baby.

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