scholarly journals Emergency LSCS in a Parturient with Pre-eclampsia and HELLP Syndrome with Altered Renal Functions Managed with Regional Anaesthesia

2021 ◽  
Author(s):  
Pooja Arpan Shah ◽  
Mehul Mehta ◽  
Jatin Patel
Keyword(s):  
Liver Enzyme ◽  
Hellp Syndrome ◽  
Regional Anaesthesia ◽  
Blood Smear ◽  
Elevated Liver Enzyme ◽  
Peripheral Blood Smear ◽  
Anaesthetic Management ◽  
Advanced Stage ◽  
Renal Functions ◽  
Pedal Oedema

Haemolysis, Elevated Liver enzyme levels, and Low Platelet (HELLP) syndrome is characterised by haemolysis (abnormal peripheral blood smear, increased unconjugated bilirubin), elevated liver enzyme and decreased platelet count. It is an advanced stage of pre-eclampsia. Pre-eclampsia is defined as blood pressure >140/90 mmHg with proteinuria with or without pedal oedema. HELLP syndrome account for 24% of maternal mortality and 40% of perinatal mortality. Anaesthetic management of such parturient is also challenging. This report is about a 35-year-old female patient with HELLP syndrome and altered renal function requiring LSCS. She was managed with regional anaesthesia.

Alpha hemoglobin stabilizing protein (AHSP) in hemolysis elevated liver enzyme and low platelet (HELLP) syndrome, intrauterine growth restriction (IUGR) and fetal death

2005 ◽  
Vol preprint (2007) ◽  
pp. 1
Author(s):  
Monica Emanuelli ◽  
Davide Sartini ◽  
Valentina Rossi ◽  
Alessandra Corradetti ◽  
Beatrice Landi ◽  
...  
Keyword(s):  
Liver Enzyme ◽  
Intrauterine Growth Restriction ◽  
Hellp Syndrome ◽  
Fetal Death ◽  
Elevated Liver Enzyme ◽  
Growth Restriction ◽  
Intrauterine Growth

scholarly journals Eklampsia dan Sindroma HELLP pada Kehamilan Awal: Penegakan Diagnosis dan Manajemen Anestesia

2020 ◽  
Vol 1 (1) ◽  
pp. 40-6
Author(s):  
Fahmi Agnesha ◽  
Sri Rahardjo
Keyword(s):  
Liver Enzyme ◽  
Hellp Syndrome ◽  
Maternal Morbidity ◽  
Fetal Death ◽  
Elevated Liver Enzyme ◽  
Clinical Manifestations ◽  
Morbidity And Mortality ◽  
Anesthesia Management ◽  
Maternal Morbidity And Mortality ◽  
Severity Of The Disease

Preeklampsia merupakan salah satu penyebab morbiditas dan mortalitas ibu hingga saat ini. Penyakit ini memiliki beberapa bentuk manifestasi klinis yang merupakan gambaran dari perburukan dari preeklampsia diantaranya adalah eklampsia dan sindroma HELLP (hemolysis, elevated liver enzyme dan low platelet). Kedua perburukan preeklampsia tersebut biasa terjadi pada usia kehamilan 27 hingga 37 minggu, namun semakin dini onset penyakit ini muncul prognosis bagi ibu akan semakin buruk. Seorang perempuan usia 34 tahun, gravida 3 paritas 1 abortus 1 hamil 24 minggu, janin intra uterine fetal death. Pasien datang dikarenakan kejang seluruh badan selama 5 menit sekitar 30 menit yang lalu sebelum masuk rumah sakit. Berdasarkan pemeriksaan fisik didapatkan hipertensi dengan tekanan darah 180/110 mmHg. Selain itu dari pemeriksaan penunjang didapatkan trombositopenia 94.000, SGOT 350 IU/L and SGPT 285 IU/L. Pasien didiagnosis dengan eklampsia dan sindroma HELLP, kemudian dilakukan terminasi kehamilan melalui seksio sesarea darurat dengan anestesia umum. Pembahasan: manajemen anestesia pada ibu hamil dengan eklampsia dan sindroma HELLP memiliki beberapa pertimbangan khusus antara lain adanya kesulitan intubasi, kemungkinan terjadinya peningkatan tekanan intrakranial dan juga efek pemberian anti kejang terhadap kontraksi rahim. Melalui penegakan diagnosis dan pengenalan risiko yang mungkin dapat terjadi pada pasien dengan eklampsia dan sindroma HELLP dapat direncanakan tindakan dan manajemen anestesia yang lebih baik sehingga morbiditas dan mortalitas ibu dengan eklampsia dan sindroma HELLP dapat diturunkan.   Eclampsia and HELLP Syndrome in Early Pregnancy: Diagnosis and Management of Anesthesia Abstract Preeclampsia is one of the leading cause maternal morbidity and mortality. It has various clinical manifestations that describe the severity of the disease include eclampsia and HELLP syndrome (hemolysis, elevated liver enzyme dan low platelet). Those worsening of preeclampsia usually happen during 27 to 37 weeks of gestation. Even though the earlier the onset showed the worse the prognosis is. A pregnant woman 34 years old, gravidy 3 parity 1 abortus 1, 24 weeks gestational age with intra uterine fetal death. Patient had chief complain for seizure before admission. From the physical examination found that patient has severe hypertension with blood pressure 180/110 mmHg. The laboratory result showed trombositopenia 94.000, SGOT 350 IU/L and SGPT 285 IU/L. Patient diagnosed with eclampsia and HELLP syndrome and then did emergency caesarean section with general anesthesia. Discussion: The anesthesia management in this case should be specifics due to the patient condition circumstances with eclampsia and HELLP syndrome. We should prepare for difficult airway, intracranial pressure increase and effect of anticonvulsant agent to the uterine tone. By diagnose and identify the risk of eclamptic and HELLP syndrome patient carefully we can plan the better procedure and anesthesia management that maternal morbidity and mortality can be reduced.

scholarly journals An Unusual Presentation of Partial Hemolysis, Elevated Liver Enzyme Levels, and Low Platelet Levels Syndrome in a Case of in vitro Fertilization-DEM Pregnancy

2016 ◽  
Vol 7 (2) ◽  
pp. 73-75
Author(s):  
Nupur Garg ◽  
Revathi Govind ◽  
Smitha Avula
Keyword(s):  
Liver Enzyme ◽  
Lupus Erythematosus ◽  
Hellp Syndrome ◽  
Elevated Liver Enzyme ◽  
Unusual Presentation ◽  
Retroperitoneal Hemorrhage ◽  
Increased Risk ◽  
Autoimmune Conditions ◽  
Donor Embryo

ABSTRACT Pregnancy in women with systemic lupus erythematosus (SLE) or autoimmune conditions is complicated by complementmediated injury and is associated with increased risk of preeclampsia. Immunological intolerance between the mother and the fetus may play an important role in the pathogenesis of preeclampsia. The present case highlights the influence of susceptibility to preeclampsia/hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome due to preexisting autoimmune conditions. In vitro fertilization (IVF)- Donor embryo pregnancy (DEM) pregnancy is one such unique scenario where there exists partial immunological disparity between the native intrauterine environment and the implanted donor embryo that could predispose to autoimmune problems in pregnancy. This case illustrates a similar scenario in which a pregnant woman with IVF-DEM conception and antinuclear antibody (ANA) positive status manifested with a normotensive partial HELLP syndrome which was reiterated by the fact that there was clinical evidence of retroperitoneal hemorrhage intraoperatively during cesarean along with the neonate who was diagnosed to have L-carnitine deficiency, which is unique to fetuses with mothers of HELLP syndrome. How to cite this article Garg N, Govind R, Avula S, Rao KA. An Unusual Presentation of Partial Hemolysis, Elevated Liver Enzyme Levels, and Low Platelet Levels Syndrome in a Case of in vitro Fertilization-DEM Pregnancy. Int J Infertil Fetal Med 2016;7(2):73-75.

scholarly journals SIMPLE PERIPHERAL BLOOD SMEAR FINDINGS OF COVID-19 PATIENTS PROVIDE INFORMATION ABOUT THE SEVERITY OF THE DISEASE AND THE DURATION OF HOSPITAL STAY.

2020 ◽  
Vol 13 (1) ◽  
pp. e2021009
Author(s):  
Ilhami Berber ◽  
Ozlem Cagasar ◽  
Ahmet Sarıcı ◽  
Nurcan Kirici Berber ◽  
Ismet Aydogdu ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Blood Smear ◽  
Laboratory Data ◽  
Peripheral Blood Smear ◽  
Clinical Severity ◽  
Advanced Stage ◽  
Peripheral Smear ◽  
Duration Of Hospitalization ◽  
Severity Of The Disease ◽  
Mature Lymphocyte

Backround Data about the morphological changes of Covid-19 infection in peripheral blood smear are limited and association with clinical severity of the disease are not known yet. We aimed to examine the characteristics of the cells detected in the pathological rate and / or appearance and whether these findings are related to the clinical course by evaluating the peripheral blood smear at the time of diagnosis in Covid-19 patients. Methods Clinical features, laboratory data, peripheral blood smear of fifty patients diagnosed with Covid-19 by PCR was evaluated at diagnosis. Peripheral smear samples of the patients were compared with the age and sex matched 30 healthy controls. Pictures were taken from the paitients’peripheral blood smear. Patients were divided into two groups.  Early and advanced stage patient groups were compared in terms of laboratory data and peripheral smear findings. The relationship between the laboratory values of all patients and the duration of hospitalization was analyzed. Results Pseudo pelger-huet, atypical lymphocytes, vacuole monocytes and pycnotic neutrophils rates were high in the patient group. Increased pseudo pelger-huet anomaly, psodo-pelger huet/mature lymphocyte ratio, decreased number of mature lymphocytes, and eosinophils in peripheral blood smear were observed in the advanced stage patients (p <0.05). A negative correlation was observed between the duration of hospitalization and mature lymphocyte, and monocytes with vacuoles rates (p <0.05). Conclusion Peripheral smear is a cheap, easily performed, and rapid test. Increased pseudo-pelger huet anomaly/mature lymphocytes rate is suggesting advanced stage disease, while high initial monocytes with vacuoles and mature lymphocyte rates at the time of diagnosis may be an indicator of shortened duration of hospitalization.

Pregnancy Outcome in Impaired Liver Function in Pre-eclampsia

2020 ◽  
Vol 49 (2) ◽  
pp. 9-13
Author(s):  
Amina Khatun ◽  
Abul Masud Md Nurul Karim ◽  
Aslam Hossain Biswas ◽  
Md Tarique Mehedi Parvez
Keyword(s):  
Liver Function ◽  
Pregnancy Outcome ◽  
Liver Enzyme ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Elevated Liver Enzyme ◽  
Epigastric Pain ◽  
Clinical Severity ◽  
Third Trimester ◽  
Major Complications

Pre-eclampsia induced liver disease is a disorder unique to pregnancy and is frequently seen in third trimester. Severe pre-eclampsia is defined by extreme elevation in systemic blood pressure and evidence of organ compromise. HELLP syndrome is a unique liver related disorder of pregnancy that was first described by Weinstein in1982 as a constellation of clinical and laboratory abnormalities in pregnant women in their third trimester. This disorder was termed HELLP syndrome with (H) for haemolysis, (EL) for elevated liver enzymes and (LP) for low platelet counts. This is a severe variant of pre-eclampsia. Objective of this study was to determine the alteration of liver function in preeclampsia and its correlation with the clinical severity as well as the perinatal outcome. This was a one-year prospective observational cross sectional study included 100 patients with pre-eclampsia. Severity of the pre-eclampsia clarified clinically. Pre-eclampsia patients having history of hepatitis, cirrhosis of liver, gallbladder diseases and other pre-existing medical disorders that altered liver function were excluded from this study. The mean age of the patients was 25.3+4.9 years ranging from 18 to 37 years. One third of the patients (33.3%) were in the age group 28 to 32 years. Out of 100 patients, 58% belongs to poor income group. Among the studied samples 17% had epigastric pain and discomfort, 13% had complaints of vomiting and 43% develop severe pre-eclampsia. Among the Patients with altered hepatic enzyme level, 8.33% had complaints of epigastric pain, 6.66% complains vomiting. Maximum patients (66.6%) with elevated liver enzyme had no major complications whereas 33.4% of patients developed major complications. Patients with severe pre-eclampsia have elevated liver enzyme whereas patients of mild symptoms had normal liver enzymes level. Cases with raised serum biochemical markers had strong association with complications of severe pre-eclampsia. Pregnancy outcome in severe pre-eclampsia with hepatic involvement is grievous. Graves sequlae of pre-eclampsia can be prevented and minimized by timely institutional intervention. Post-partum followup would help to find out other parameters of pregnancy outcome. Bangladesh Med J. 2020 May; 49(2) : 9-13

scholarly journals Delayed Diagnosis of Colonic Adenocarcinoma in a 30-Year-Old Postpartum Woman Misdiagnosed with HELLP Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Alexander J. Maqueira ◽  
Ahmad O. Rifai ◽  
Courtney Albury ◽  
William A. Kantrales ◽  
David Rydell ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Liver Enzyme ◽  
Hellp Syndrome ◽  
Elevated Liver Enzyme ◽  
Delayed Diagnosis ◽  
Hepatic Metastases ◽  
Postpartum Woman ◽  
Intrauterine Pregnancy ◽  
Persistent Symptoms ◽  
Elevated Liver Enzymes

Colon cancer is a rare diagnosis in 30-year-old women, which may be further complicated by their concurrent gravid status. Several physiological changes that occur during an intrauterine pregnancy (IUP) can mask symptoms of early colon cancer. Our patient was a 30-year-old, Gravida 2, Para 0 woman with an uncomplicated pregnancy until the 35th week of gestation when she developed preeclampsia and symptoms suggestive of early hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. Following induction of labor and the subsequent, uncomplicated vaginal delivery, the patient developed symptoms of nausea, vomiting, and constipation with abdominal pain and bloating. Abdominal computed tomography (CT) revealed a large mass in the right colon along with the involvement of periaortic lymph nodes and the presence of liver metastases. Hepatic metastases were possibly responsible for the patient’s elevated liver enzyme levels, which were initially considered to have been caused by HELLP syndrome because the patient also had preeclampsia. The rarity of colon cancer in young, pregnant patients with no family history, such as in this case, results in poor prognosis owing to nonspecific symptoms of the developing malignancy being attributed to pregnancy, which further delays diagnosis and subsequent therapy. Of 29 cases of colon cancer in pregnant patients recorded till date, this is the first report of a stage 4 adenocarcinoma of the colon with hepatic metastasis, elevated liver enzyme levels, and increased blood pressure with associated preeclampsia, which was diagnosed in the postpartum period. It may be important to consider broader differential diagnoses in expectant patients presenting with unusual and persistent symptoms.

PENENTUAN KRITERIA PENILAIAN KESAN JUMLAH LEUKOSIT PADA PEMERIKSAAN APUSAN DARAH TEPI

2018 ◽  
Vol 3 (2) ◽  
pp. 52-61
Author(s):  
Dzikra Arwie ◽  
Islawati
Keyword(s):  
Data Analysis ◽  
Statistical Analysis ◽  
Blood Cells ◽  
Blood Smear ◽  
White Blood Cells ◽  
Peripheral Blood Smear ◽  
Field Of View ◽  
Laboratory Observation ◽  
Number Of Cells

Leukocytes or white blood cells have a characteristic characteristic of different cells. Determination of the impression of the number of leukocytes is determined in the number of cells in the field of view. While the number of viewable field cells expressed is still quite varied. The purpose of this study was to determine the number of leukocytes in the field of view and expressed the impression of a sufficient amount. This research was conducted at the Laboratory of Health Analyst Department Panrita Husada Bulukumba on 9 April 2017 to 14 July 2017. This type of research is a laboratory observation that aims to determine the criteria for assessing the impression of the number of leukocytes on a peripheral blood smear. Data analysis using statistical analysis is the average and standard deviations to determine the impression of the number of leukocytes and use 3 inspection zones. The results of this study obtained results in zone IV the number of leukocyte impressions said to be sufficient was 7-10, in zone V the number of leukocyte impressions said to be sufficient was 4-9, and in zone VI the number of leukocyte impressions said to be sufficient was 3-8.  

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