Nephrology

Answer 3 Immediate delivery. HELLP syndrome is a serious disorder that is life-threatening to the mother and fetus. It usually occurs between 28 and 36 weeks gestation but may occur postpartum in up to 30% of cases. Some believe HELLP syndrome is a severe form of preeclampsia. Prompt delivery is critical to the management of this syndrome. Platelet infusion should only be given in patients with severely low platelet counts (< 20 × 103/µL), those with significant bleeding, or in patients with a platelet count less than 40 × 103/µL but who may require cesarean delivery. Right upper quadrant ultrasound may show hepatic infarction or subcapsular hematoma but has no role in acute management of this patient. Bedrest alone would risk the life of the mother and fetus. When HELLP syndrome presents earlier in gestation, corticosteroids are given to improve lung maturity of the fetus before immediate delivery. Click here to return to the questions

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