Intracranial haemorrhage - the feared complication of HELLP syndrome - Case report
Baglyas, S.
Intracranial haemorrhage - the feared complication of HELLP syndrome - Case report - 2016
NMUH Staff Publications EMBASE 17
<span style="font-size: 10pt;">Introduction: HELLP syndrome is a serious complication in pregnancy with possible life-threatening consequences. Up to 0.9% of all the pregnancies and 10-20% of the severe preeclampsia are complicated with haemolysis, elevated liver enzymes, and low platelets count. About 70% of the cases develop before delivery, the majority between the 27th and 37th gestational weeks. Although the etiopathogenesis of this syndrome remains unclear, histopathologic findings in the liver include intravascular fibrin deposits that presumably may lead to hepatic sinusoidal obstruction, intrahepatic vascular congestion, and increased intrahepatic pressure with ensuing hepatic necrosis, intraparenchymal and subcapsular hemorrhage, and eventually capsular rupture. The syndrome is a progressive condition and serious complications are frequent. The overall mortality of the pregnancies complicated with HELLP syndrome is around 1%, and cerebral hemorrhage or stroke to be the primary cause of death in 26% and the most contributing factor in another 45% of the deaths. Case presentation:We present a case of a 36-year-old woman whose pregnancy was complicated with HELLP syndrome on the 37th gestational week. The patient was admitted to the ICU after having caesarean section in general anesthesia. Despite of all the efforts and supportive care, her symptoms did not improve; the syndrome was complicated with severe intracranial bleeding and the patient died. Conclusion: Reviewing our case, it could be highlighted that HELLP syndrome is a serious and life-threatening complication of the pregnancies. The major cause of death is still intracranial hemorrhage, and despite of early recognition the management could be challenging and the outcome is frequently fatal. </span>
Intracranial haemorrhage - the feared complication of HELLP syndrome - Case report - 2016
NMUH Staff Publications EMBASE 17
<span style="font-size: 10pt;">Introduction: HELLP syndrome is a serious complication in pregnancy with possible life-threatening consequences. Up to 0.9% of all the pregnancies and 10-20% of the severe preeclampsia are complicated with haemolysis, elevated liver enzymes, and low platelets count. About 70% of the cases develop before delivery, the majority between the 27th and 37th gestational weeks. Although the etiopathogenesis of this syndrome remains unclear, histopathologic findings in the liver include intravascular fibrin deposits that presumably may lead to hepatic sinusoidal obstruction, intrahepatic vascular congestion, and increased intrahepatic pressure with ensuing hepatic necrosis, intraparenchymal and subcapsular hemorrhage, and eventually capsular rupture. The syndrome is a progressive condition and serious complications are frequent. The overall mortality of the pregnancies complicated with HELLP syndrome is around 1%, and cerebral hemorrhage or stroke to be the primary cause of death in 26% and the most contributing factor in another 45% of the deaths. Case presentation:We present a case of a 36-year-old woman whose pregnancy was complicated with HELLP syndrome on the 37th gestational week. The patient was admitted to the ICU after having caesarean section in general anesthesia. Despite of all the efforts and supportive care, her symptoms did not improve; the syndrome was complicated with severe intracranial bleeding and the patient died. Conclusion: Reviewing our case, it could be highlighted that HELLP syndrome is a serious and life-threatening complication of the pregnancies. The major cause of death is still intracranial hemorrhage, and despite of early recognition the management could be challenging and the outcome is frequently fatal. </span>