Successful management of severe HELLP syndrome: A case report

Abstract

Haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is a severe pregnancy complication that is life-threatening for both mother and fetus. When HELLP syndrome associates with disseminated intravascular coagulation (DIC) or with other complications, it is necessary to terminate the pregnancy. We present a case of a 26-year-old primigravida with rare combination of HELLP syndrome with coagulopathy and renal complication at 34 weeks of gestation. She had emergency caesarean section followed by haemorrhagic complications, DIC and acute renal failure.  During her stay in intensive care unit, she had massive blood transfusion and fresh frozen plasma. She had haemodialysis because of acute renal failure. A gradual improvement of her condition was observed after exploration and drainage of haemoperitoneum. After 13 days she was discharged from the intensive care unit.
HELLP syndrome complicated by DIC and Acute kidney injury is a condition that is associated with high maternal and perinatal morbidity and mortality. Prompt recognition, teamwork and treatment with timely administration of blood products along with other supportive care is crucial in the management of this life-threatening and challenging condition.

Key words: AKI, Preeclampsia, Disseminated intravascular coagulation, HELLP syndrome