Hemolysis, Elevated Liver Enzymes and Low Platelet (HELLP) Syndrome: A Dreaded Complication of Pre-eclampsia in a Young Nigerian Woman

Abstract

HELLP Syndrome is a fatal rare pregnancy-related syndrome characterised by hemolysis, elevated liver enzymes and low platelet count; occurring in 0.5-0.9% of all pregnancies and in 10-20% of pregnancies with severe pre-eclampsia. HELLP Syndrome is a complication of severe pre-eclampsia; seventy percent of the cases are developed during the antepartum period, mainly between the 27th and 37th gestational weeks. Thirty percent are diagnosed postpartum often within 48hrs post-delivery. It is a dreaded obstetric catastrophe that is associated with both maternal and perinatal morbidity and mortality such as maternal disseminated intravascular coagulopathy, thrombocytopenia, intracranial hemorrhage, eclampsia, paralysis, liver rupture, maternal collapse and death as well as utero-placental insufficiency, intrauterine fetal death and stillbirth. This obstetric complication is commonly diagnosed in pregnant women with poorly controlled pre-eclampsia, diabetes mellitus, renal disease and those who are not compliant with routine antenatal clinic visits thus, periconceptional care, adequate management of medical conditions of pregnancy and strict compliance to antenatal care services play vital roles in the prevention of HELLP Syndrome. This case report presents the timely diagnosis and prompt management of a 35-year-old gravida 2 para 1 woman diagnosed with HELLP syndrome at 32weeks gestational age at the obstetrics and gynecology department in Nigerian Navy Reference Hospital Calabar, Nigeria.