Early Development of HELLP Syndrome: A Case Report

The HELLP syndrome is a severe complication of pregnancy. It usually occurs in the middle of the third trimester. In our case, however, a very early development is reported. Dimiter B. Georgiew, MD, District Hospital, 7700 Targoviste (Bulgaria) the mother’s chest X-ray examination we found small bilateral liquid collections. The patient’s condition deteriorated progressively, despite strict bed rest and the administered therapy – continuous magnesium sul-fate infusion 1.5 g/h, clonidinine 0.1 mg and diazepam lOmgi.m. 3 times daily. Blood pressure remained elevated, fluctuating between 150/100 and 200/120 mm Hg, and the headache became more severe. The woman complained of epigastric and right subcostal discomfort; nausea and vomiting appeared. Forty-two hours after admission a short-lasting seizure was registered. Therefore, we classified the case as HELLP syndrome and decided to interrupt the pregnancy in order to save the mother’s life. Sectio parva was performed 44 h after admission and a female fetus (320 g, 24 cm) was delivered, whose vital signs soon stopped. The postoperative course was uneventful with a rapid return to normal of all clinical symptoms and laboratory data. The women was discharged 13 days after the operation in good physical health. The figures in parentheses indicate the normal range.