CASE REPORTS   

Minerva Ginecologica 2008 October;60(5):445-50

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

The development of disseminated intravascular coagulation in hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP) at very early gestational age

Indraccolo U. ¹, Gentile G. ², Manfreda V. M. ², Pomili G. ³

¹ Department of Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy 2 Department of Internal Medicine, University of Perugia, Perugia, Italy 3 Department of Obstetrics and Gynecology, Policlinico Monteluce, Perugia, Italy

Hemolysis, elevated liver enzymes, and low platelet count syndrome(HELLP) is a severe pregnancy complication since it 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; however, due to fetal prematurity, it may be advisable to wait for the effectiveness of the corticosteroid prophylaxis of neonatal respiratory distress syndrome when such complications are not present. This article reports an initially mild HELLP syndrome case, with onset at week 26 and two days of pregnancy, where it was necessary to wait for the effectiveness of respiratory distress prophylaxis and, consequently, to carry out a close monitoring of the onset and worsening of DIC. Tests for blood cell distribution width, D-dimer, plasmatic electrolytes and urinary sediment, which undergo precocious and rapid variations in DIC, are quickly processed, and useful for the conservative management of HELLP.