HELLP syndrome in pregnancies below 26th week

Pawelec, Małgorzata; Pałczyński, B; Karmowski, A

doi:10.3109/14767058.2011.592875

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…There is a reported association between APLS and early-onset HELLP syndrome. A retrospective analysis of HELLP syndrome cases diagnosed below 26 weeks gestation reported only 6 total cases, all of whom had APLS [ 7 ]. Another retrospective case series at a large obstetric tertiary care center found that about half of early-onset second-trimester HELLP cases were associated with APLS, with the earliest reported case occurring at 18 weeks [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Early HELLP Syndrome or Catastrophic Antiphospholipid Syndrome? A Diagnostic Dilemma

Bae¹,

Comfort²,

Ng³

et al. 2023

Cureus

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Hypertensive disorders of pregnancy typically occur in the third trimester, with earlier presentations associated with underlying disorders such as antiphospholipid syndrome (APLS). We describe a case of a young primigravida presenting at 15 weeks 6 days gestation with epigastric pain, vomiting, new-onset severe-range hypertension, and subsequent development of anemia, thrombocytopenia, and transaminitis. Antiphospholipid antibodies (aPL) were triple-positive and imaging was negative for thrombosis. She was treated with aspirin, therapeutic anticoagulation, and ultimately dilatation and evacuation with initial postoperative improvement. Her symptoms returned postoperative day 3 and resolved following re-initiation of therapeutic anticoagulation. The differential diagnosis for hypertensive disorders of pregnancy is wide, particularly in second-trimester gestation, and includes catastrophic antiphospholipid syndrome (CAPS), lupus flare, microangiopathic anemias, and acute fatty liver of pregnancy. This case was an atypical presentation not clearly explained by any of the above diagnoses and required a multidisciplinary approach. Obstetric patients with high-risk aPL must be meticulously investigated with a broad differential to guide diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Early HELLP Syndrome or Catastrophic Antiphospholipid Syndrome? A Diagnostic Dilemma

Bae¹,

Comfort²,

Ng³

et al. 2023

Cureus

View full text Add to dashboard Cite

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“…Based on this evidence, we did not consider conservative management in either syndrome presentation of our patient. The suggestion that HELLP syndrome at GA < 26 weeks occurs only in women with superposed preeclampsia or with positive antiphospholipid antibodies can be contested [ 17 ]. In our case, we ruled out antiphospholipid syndrome and, in her first pregnancy, our patient was not hypertensive before disease onset.…”

Section: Discussionmentioning

confidence: 99%

Recurrent HELLP Syndrome at 22 Weeks of Gestation

Kaščák

Paskala

Péter

et al. 2017

Case Reports in Obstetrics and Gynecology

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We describe a case of a woman who presented with HELLP syndrome in two subsequent pregnancies (age 36 and 40), at gestational age of 22 weeks in both pregnancies with a rapid onset and progression. She presented with characteristic clinical symptoms and laboratory findings. Both pregnancies were delivered by caesarean sections due to deterioration in the mother's condition, although neither pregnancy progressed into the 1st stage of the syndrome according to Mississippi classification. This case highlights the admittedly rare but serious condition of recurring HELLP syndrome at a gestational age before the limit of viability of the fetus. In such situations, pregnancy termination should be considered to minimise risk to the mother's life and health.

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“…Further haemolysis parameters [164]: " Detection of fragmentocytes in a peripheral blood smear (54-86 %) " Total bilirubin raised (47-62%) LDH is not a haemolysis-specific parameter in HELLP syndrome [164,192,196,197]; however it correlates with the severity of the disease [200]. An increase in C-reactive protein is detected in up to 62 % of cases of HELLP syndrome and is not a result of infection [199,[201][202][203][204][205].…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Treatment of Hypertensive Pregnancy Disorders. Guideline of DGGG (S1-Level, AWMF Registry No. 015/018, December 2013)

Stepan

Kuse-Föhl

Klockenbusch

et al. 2015

Geburtshilfe Frauenheilkd

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!Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Hypertensive pregnancy disorders contribute significantly to perinatal as well as maternal morbidity and mortality worldwide. Also in Germany these diseases are a major course for hospitalization during pregnancy, iatrogenic preterm birth and long-term cardiovascular morbidity. Methods: This S1-guideline is the work of an interdisciplinary group of experts from a range of different professions who were commissioned by DGGG to carry out a systematic literature search of positioning injuries. Members of the participating scientific societies develop a consensus in an informal procedure. Afterwards the directorate of the scientific society approves the consensus. Recommendations: This guideline summarizes the state-of-art for classification, risk stratification, diagnostic, treatment of hypertensive pregnancy disorders.

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HELLP syndrome in pregnancies below 26th week

Abstract: HELLP syndrome in early pregnancy may indicate the presence of aPL antibodies. It may also be a clinical symptom of APS. A surge in blood pressure is a clinical forerunner of the coming HELLP syndrome. HELLP syndrome in women with APS is characterized by low level of platelets.

Cited by 7 publications

References 11 publications

Early HELLP Syndrome or Catastrophic Antiphospholipid Syndrome? A Diagnostic Dilemma

Early HELLP Syndrome or Catastrophic Antiphospholipid Syndrome? A Diagnostic Dilemma

Recurrent HELLP Syndrome at 22 Weeks of Gestation

Diagnosis and Treatment of Hypertensive Pregnancy Disorders. Guideline of DGGG (S1-Level, AWMF Registry No. 015/018, December 2013)

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