Sign in. Editorial Policies. Send email. Copy url:. Paulina Budna. Anna W. PlumX metrics:. HELLP syndrome is rare, with an incidence of 0. The highest risk of disease manifestation occurs during the third trimester of pregnancy. The timing of the onset of symptoms does not affect these test results. The aetiology of HELLP syndrome is not precisely defined, but possible causes include a genetic background of inflammatory, immunological, or metabolic disorders [1, 3].
HELLP syndrome symptoms manifest in a specific order. The first is thrombocytopaenia, followed by an increase in alanine aminotransferase ALT and aspartate aminotransferase AST activity, while the last element is intravascular haemolysis. They differ in the laboratory parameters applied. To date, there are relatively few studies to assess which set of classification criteria is more favourable for the course of treatment [9].
Alternatively, the Tennessee classification divides HELLP syndrome into 2 categories: either partial having 1 or 2 abnormalities or full having all 3 abnormalities [2, 4]. Managing the diagnosis of HELLP syndrome is dependent on the pregnancy stage and the condition of the mother and child.
It is recommended that the pregnancy be completed beyond 34 weeks of pregnancy Hbd. Between 27 and 34 Hbd, it is necessary to stabilize the patient by the administration of corticosteroids to stimulate foetal lung maturation and prevent RDS, and then termi-nate the pregnancy after 48 h.
Earlier than 27 Hbd, if the conditions of the mother and baby are stabilized, a wait-and-see approach is adopted [10]. Simul-taneous use of magnesium sulphate and nifedipine is not advisable, due to the induction of excessive hypotension [10]. Platelet cell concentrate PPC transfusion is necessary. In cases of coagulation disorders, fresh frozen plasma or cryo-precipitate should be transfused [12].
