scholarly journals Liver Bleeding Due to HELLP Syndrome Treated With Embolization and Liver Transplantation: A Case Report and Review of the Literature

2021 ◽  
Vol 8 ◽  
Author(s):  
Valentina Messina ◽  
Daniele Dondossola ◽  
Maria Chiara Paleari ◽  
Gianluca Fornoni ◽  
Daniela Tubiolo ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hellp Syndrome ◽  
Multidisciplinary Approach ◽  
Liver Enzymes ◽  
Case Presentation ◽  
Foetal Growth Restriction ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
Low Platelet Count ◽  
Liver Bleeding

Background: Liver bleeding secondary to haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is uncommon, but a life-threatening peripartum condition that needs a prompt multidisciplinary approach.Case Presentation: In this study, we presented a case of 28-year-old pregnant woman, who was presented to the obstetrics department with signs of preeclampsia and foetal growth restriction. An emergency caesarean section was performed, and the patient developed a HELLP syndrome complicated by spontaneous liver rupture. After radiological and surgical procedures, liver failure became evident and liver transplantation was successfully performed. The patient and her daughter are now alive.Conclusions: Despite the rarity of this disease, liver complications due to HELLP syndrome must be properly diagnosed and treated given the gravity of the possible evolution in young women. After diagnosis, the patients must be treated in specialised centres with gynaecological, liver surgery, and transplant skills.

scholarly journals Fetomaternal outcome in pregnancy with HELLP syndrome

2020 ◽  
Vol 9 (7) ◽  
pp. 2860
Author(s):  
Prachi M. Shelat ◽  
Rupa C. Vyas ◽  
Sapana R. Shah ◽  
Naimish D. Nathwani
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Care Center ◽  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Intrauterine Death ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Background: HELLP Syndrome is a serious complication of pregnancy induced hypertensive disorders. It is defined as a triad of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Objectives of this study was to find out incidence of HELLP syndrome in pre-eclampsia, eclampsia and its overall incidence. To analyse the clinical profile of HELLP syndrome. To study maternal and perinatal outcome including morbidity and mortality.Methods: A retrospective study was conducted from July 2017 to September 2019 at a tertiary care center with inclusion criteria of abnormal peripheral blood smear, elevated liver enzymes (LDH, aspartate aminotransferase), and low platelet count.Results: HELLP syndrome was more common in younger age group (45%) and in primigravida (52.5%). Most of the patients presented at >36 weeks of gestation (40%) and most of the patients delivered by caesarean section (67.5%). Maternal complications were acute renal failure (27.5%), DIC (22.5%), maternal mortality (7.5%). Neonatal complications associated were intrauterine death (27.5%), prematurity (25%) and intrauterine growth retardation (15%).Conclusions: Thus, HELLP syndrome requires an early diagnosis and early initiation of treatment at tertiary care center with all the medical facilities available.

scholarly journals Ruptured subcapsular hepatic hematoma complicating severe preeclampsia with haemolysis, elevated liver enzymes, low platelet count syndrome: a case report

2020 ◽  
Vol 9 (11) ◽  
pp. 4726
Author(s):  
Ashok R. Anand ◽  
Binita H. Shah ◽  
Pratibha Vashisth
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Treatment Options ◽  
Severe Preeclampsia ◽  
Medical Support ◽  
Artery Ligation ◽  
Hepatic Hematoma ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Subcapsular liver hematoma is rare complication of severe preeclampsia and HELLP syndrome, thus making it essential for these patients to be followed up in critical and intensive care units for advanced medical support with fluid and electrolyte management and replacement of blood products while treating underlying disorders. Treatment options have to be individualised and vary from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this paper we report a case of ruptured hepatic hematoma in a 35 year old female, few hours within delivery, a complication of severe preeclampsia and HELLP syndrome

scholarly journals HELLP syndrome, a difficult diagnosis: a case report

2019 ◽  
Vol 8 (4) ◽  
pp. 1686
Author(s):  
Shweta Pradhan ◽  
Somen Bhattacharjee
Keyword(s):  
Case Report ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Severe Thrombocytopenia ◽  
Atypical Presentation ◽  
Third Trimester ◽  
Diagnostic Dilemma ◽  
Present Case Report ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

HELLP is an acronym that refers to a syndrome characterized by Haemolysis with a microangiopathic blood smear, Elevated Liver enzymes, and a Low Platelet count.  Recent studies suggested that some women will develop HELLP without the manifestations of classical symptoms. Authors present the case of a 22-year-old normotensive primigravida who went into severe thrombocytopenia and haemolysis leading to DIC, finally the diagnosis of normotensive HELLP syndrome was made. Present case report attempts to illustrate the diagnostic dilemma that a clinician faces in diagnosing an atypical presentation of HELLP syndrome. Management of jaundice during pregnancy especially in third trimester remains a dilemma for the obstetrician because of its varied aetiology, unpredictable prognosis and guarded perinatal outcome. Authors therefore recommend a rational stepwise approach toward the diagnosis of HELLP syndrome and its atypical presentation.

scholarly journals A study of maternal and perinatal outcome in cases of HELLP and partial HELLP syndrome

2017 ◽  
Vol 6 (12) ◽  
pp. 5491 ◽  
Author(s):  
Kanchan Durugkar
Keyword(s):  
Prospective Study ◽  
Hellp Syndrome ◽  
Perinatal Outcome ◽  
Liver Enzymes ◽  
Severe Preeclampsia ◽  
Perinatal Morbidity ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Laboratory Investigations ◽  
In Pregnancy

Background: The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. The objective of the present prospective study is to study on incidence, diagnosis, and variable presentations of HELLP syndrome in preeclampsia to analyse the severity and complications, as it is associated with maternal, perinatal morbidity and mortality. HELLP syndrome is difficult to diagnose when it presents with atypical clinical features.Methods: In the prospective study of 300 admitted cases with more than 20 weeks of gestation, were having preeclampsia. The selected cases were analyzed clinically with relevant history, clinical data and detailed laboratory investigations made for better analyses of complications and outcome in HELLP syndrome.Results: Under further clinical diagnosis of 300 cases of preeclampsia, 34 cases (11.33%) were of HELLP Syndrome and 44 (14.66%) cases were of partial HELLP syndrome. The present study shows 2.9% maternal mortality in HELLP and 4.5% in partial HELLP syndrome. Perinatal mortality was 17.6% with HELLP and 25% with partial HELLP.Conclusions: The diagnosis of HELLP syndrome has been made as a severe variant and complication of severe preeclampsia and eclampsia. It needs early diagnosis, timely intervention to arrest further progress and complications like multi organ dysfunction, renal failure, DIC, abruption etc and to improve maternal and perinatal outcome.

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