1996 Volume 7 Issue 2 Pages 81-86
Two cases of HELLP syndrome are reported. Case 1: A 23-year-old primigravid woman, presented at 35 weeks' gestation with uterine contractions and vaginal bleeding. Her laboratory data showed elevated liver enzymes and low platelet count. She was suspected to have HELLP syndrome, and an emergency cesarean section was performed with delivery of a 2, 090g female infant. After delivery, jaundice and oliguria were noticed and the mother lost conscious due to severe hypoglycemia. A glucose infusion, a large volume of fresh frozen plasma and protease inhibitors were administered intravenously. She regained consciousness quickly and recovered without neurological deficits. Case 2: A 31-year-old woman, para 3, gravida 4, complained of nausea, vomiting and epigastralgia. Her blood pressure was elevated and laboratory data showed elevated liver enzymes, low platelet count and hemolysis. She was diagnosed as having HELLP syndrome and an emergency cesarean section was performed with delivery of a 1, 024g male and a 924g female infant. After delivery, oliguria was noticed and platelet count dropped to as low as 18, 000/mm3. This patient also received a large volume of fresh frozen plasma and protease inhibitors. These two cases showed high levels of maternal plasma endothelin in the first postoperative week and case 2 showed elevated tissue polypeptide antigen. These two mediators may play an important role in this syndrome.
