Two patients with postpartum HELLP syndrome after a normotensive twin pregnancy

Tilstra, Johan

doi:10.1016/0020-7292(94)90461-8

Cited by 3 publications

(1 citation statement)

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“…this is not recommended as it may significantly jeopadze maternal health. The HELLP syndrome has also been reported to present in the postpartum period (5) and in particular the report by Sibai et al (6) highlights that this may be more frequent than previously considered. Indeed in their series of 442 cases of HELLP syndrome, the condition was first recognized postpartum in 30% of cases.…”

Section: Discussionmentioning

confidence: 94%

Postpartum Microangiopathic Haemolysis Complicating Severe Preeclampsia

Sfameni

Ihle

Dobsoni

1997

Aust NZ J Obst Gynaeco

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EDITORLAL COMMENT: We accepted this paper for publication to remind readers that microangiopathic haemoIysis or the H E W syndrome can present postpartum in women with preeclampsia especially i f the condition has been treated conservatively which is usually done in an attempt to gain fetal maturity It seems to the editorial stag that the take-away message of this paper is that liver and renal function tests and coagulation studies are necessary in all paiients with preeclampsia especially if delivery is to be deferred. Also when microangiopathic haemolysis occurs postpartum it is pmbably a manifestation offurther deterioration of the severe preeclampsia and not due to haemolytic uraemic syndrome or thrombotic thmmbocytopenia purpura. The differentiation of these disorders is detailed in the Discussion section of this paper.The Editor asked the authors to perform an audit of all cases of preeclampsia seen in their institution in a 12-month interval to provide readers with insight concerning the frequency of severe preeclampsia with or without microangiopathic haemolysis. Authors'reply:A 12-month audit of the cases of preeclampsia wiihin our hospital for the year 1995 revealed 128 cases of mild preeclampsia and 130 of severe preeclampsia In 1995 there were 5.119 deliveries including all booked and nonbooked patients. Of those with severe preeclampsia there were 8 cases of HELLP syndmme, of which 4 occurred postpartum and 3 are presented in this paper. Thrombocytopenia with a plateIet count of less than 15O.ocIon was found in 26 patients. Clearly microangiopathic haemolysis is an uncommon occurrence particularly when it is seen for the first time postpartum.

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Section: Discussionmentioning

confidence: 94%