A CLINICAL CASE OF HELLP SYNDROME IN ECLAMPSIA: AN UNCOMMON COMPLICATION OF A COMMON DISEASE

Sanchayan Sinha and Sharmistha Chatterjee

Introduction: HELLP syndrome is a serious multisystem dysfunction associated with eclampsia characterized by hemolysis, elevated liver enzymes and thrombocytopenia. A 36 years old female patient came in the emergency with history of convulsion and hematuria. She had emergency Cesarean section and detoriated in the post operative period. She was transferred to ICU and received mechanical ventilation, hemodialysis, several units of packed cells and platelet concentrate. After long 32 days of hospital stay she recovered and discharged. Methodology: the patient had gradual depletion of hemoglobin and platelet levels in first 3 days of treatment in spite of Packed cell and platelet concentrate transfusion. She also had evidence of hemolysis as observed in peripheral smear. There was elevated bilirubin, WBC count, liver enzymes. There was also deranged kidney function on Day 2&3 which led to the patient to put on hemodialysis. The coagulation parameters like P time, INR and D dimer levels were also elevated during the post operative period. Conclusion: HELLP syndrome is a serious complication in pregnancy and it also increases the risk in patient with preeclampsia. Timely diagnosis and management of preeclampsia in earlier pregnancy will reduce the risk of convulsive episodes, multi organ failure and reduces the feto-maternal morbidity and mortality.