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Ginecología y obstetricia de México

versão impressa ISSN 0300-9041

Resumo

ACUNA GUILLEN, Danie Jackson  e  NOVOA, Rommy Helena. Early HELLP syndrome: a case report. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.10, pp.780-787.  Epub 08-Mar-2024. ISSN 0300-9041.  https://doi.org/10.24245/gom.v91i10.8869.

BACKGROUND:

HELLP syndrome is a severe, life-threatening complication of pre-eclampsia characterized by hemolysis, elevated liver enzymes and low platelet count. The prevalence of this syndrome is approximately 0.5-0.9% of pregnancies and 10-20% of pregnancies complicated by severe pre-eclampsia.

CLINICAL CASE:

25-year-old female patient, originally from Lima, Peru, with no personal or family history. Obstetric and gynecological history: adolescent pregnancy terminated by caesarean section due to pre-eclampsia with severe criteria at 30 weeks, requiring intensive care, with a newborn weighing 1170 grams who has developed with apparent normality. The current pregnancy is 22 weeks, determined by first trimester ultrasound, with no record of antenatal checks. Based on laboratory reports, a diagnosis of pre-eclampsia with criteria of complicated severity and HELLP syndrome was established. Given the rapid and torpid evolution of the disease, it was decided to terminate the pregnancy by caesarean section after transfusion of platelet apheresis. Anatomopathological examination revealed: placenta with accelerated villous maturation, increased perivillous fibrin and foci of old infarction.

CONCLUSIONS:

HELLP syndrome is a serious complication of pregnancy with high maternal and perinatal morbidity and mortality, especially when it occurs early in pregnancy.

Palavras-chave : Pre-eclampsia; HELLP syndrome; Haemolysis; Platelets; Maternal morbidity; Maternal mortality; First trimester ultrasound.

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