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Hellp Syndrome

HELLP syndrome is a severe form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count. It occurs in 2-12% of preeclampsia cases and 30% of cases occur postpartum. Diagnosis is based on laboratory findings including schistocytes on smear, elevated bilirubin and LDH, elevated liver enzymes, and platelet count below 100,000. Management prioritizes maternal stabilization and treats any complications, with termination of pregnancy when the mother is stable.

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Ayu Galuh Ardhi
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53 views9 pages

Hellp Syndrome

HELLP syndrome is a severe form of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count. It occurs in 2-12% of preeclampsia cases and 30% of cases occur postpartum. Diagnosis is based on laboratory findings including schistocytes on smear, elevated bilirubin and LDH, elevated liver enzymes, and platelet count below 100,000. Management prioritizes maternal stabilization and treats any complications, with termination of pregnancy when the mother is stable.

Uploaded by

Ayu Galuh Ardhi
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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HELLP SYNDROME

ADRIAN SETIAWAN.M.D.

HELLP SYNDROME

PREGNANCY

10-14% CASE

HYPERTENSION AND PROTEINURIA

PREECLAMPSIA

HELLP SYNDROME

HELLP SYNDROME
FIRST DISCRIBED BY WEINSTEIN 1982: ACRONYM OF : H : HEMOLYSIS

EL
LP INCIDENCE :

:
:

ELEVATED LIVER ENZYM


LOW PLATETLED COUNT

2%-12% AMONG PATIENTS WITH PREECLAMPSIA. 30% OCCURS IN POSTPARTUM

CRITERIA DIAGNOSTIC
LABORATORY FINDING:
HEMOLYSIS ABNORMAL PERIPHERAL SMEAR : SCHISTOCYTES AND BURR CELLS TOTAL BILIRUBIN LEVEL > 1,2 mg/Dl LACTATE DEHYDROGENASE LEVEL > 600 /L

ELEVATED LIVER FUCTION SGOT LEVEL 70 / L (LDH) LACTATE DEHYDROGENASE LEVEL > 600 /L LOW PLATELET COUNT PLATELET COUNT < 100.000/m3
THE LABORATORY DIAGNOSTIC CRITERIA USED AT THE UNIVERSITY OF TENNESSEE DIVISION OF MATERNAL FETAL MEDECINE, MEMPHIS TN. WITLIN AND SIBAI (1999)

CLASSIFICATION BASED ON PLATELET COUNT (MISSISIPPI):


CLASS I : PLATELET 50.000/m3

WITH : LDH 600 U/L SGOT 40 U/L CLASS II : PLATELET 50.000/m3 - < 100.000/m3 WITH : LDH 600 U/L SGOT 40 U/L
CLASS II : PLATELET 50.000/m3 - < 150.000/m3 WITH : LDH 600 U/L SGOT 40 U/L

MANAGEMENT OF HELLP SYNDROME


MATERNAL STABILISATION IS THE MAYOR PRIORITY

BEGIN WITH A STANDART MANAGEMENT OF SEVERE PREECLAMPSIA

HELLP SYNDROME IS NOT AN INDICATION FOR CS

MEDICAL MANAGEMENT
SAME AS SEVERE PREECLAMPSIA WHEN THROMBOCYTE COUNT IS < 50.000 mm3, 10 UNITS OF THROMBOCYTE OR FRESH WHOLE BLOOD MUST BE GIVEN WHEN PATIENT IS COMATOUS, SHE MUST BE TAKEN TO THE ICU WHEN THROMBOCYTE COUNTS IS < 50.000/mm3 FIBRINOGEN LEVEL, PROTHROMBINE TIME, PARTIAL THROMBOPLASTIN TIME, D-DIMMER MUST BE CHECKED TO FIND DIC

OBSTETRIC MANAGEMENT
WHEN MOTHERS IS STABLE TERMINATE THE PREGNANCY OR CONSERVATIVE MANAGEMENT. CONSERVATIVE MANAGEMENT CAN BE DONE WHEN :

THE BLOOD PRESSURE < 160/110 m g


THE OLIGURIA RESPONSE TO FLUID REPLACEMENT

THERE IS NO EPIGASTRIC PAIN


THE GESTATIONAL AGE IS < 34 WEEKS

COMPLICATION
THE COMPLICATIONS THAT CAN OCCUR IN HELLP SYNDROME ARE : NEUROLOGIC

DISORDER, PULMONARY EDEMA, ABRUPTIO


PLACENTA, DIC AND IUGR

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