Two Cases of HELLP Syndrome with Pregnancy Induced Hypertension Bamrasnaradure Institute 2006-2007-รายงานผู้ป่วย 2 ราย ที่มีกลุ่มอาการ HELLP syndrome ใน สตรีตั้งครรภ์ที่มีภาวะความดันโลหิตสูงระหว่างตั้งครรภ์:สถาบันบำราศนราดูร พ.ศ. 2549-2550

Abstract

           HELLP syndrome is a condition that can complicate patients with pregnancy-induced hypertension.  It is associated with increased maternal and fetal morbidity and mortality.  The incidence of HELLP syndrome is 0.2-0.6 percent of all pregnancy, while the incidence of PIH is 5-7 percent.  Two cases of HELLP syndrome with PIH, which presented with epigastric pain as the main complaint were reported.  Epigastric pain is the major presentation in 80-90 percent of HELLP syndrome.  Both cases had PIH while one of the cases also had eclampsia.  The diagnosis of HELLP syndrome was confirmed by compatible laboratory findings, low platelet count (50,000-10,000 cells/mm3), elevated liver enzymes (AST and ALT increase more than twice the upper normal limit (> 70 mg/dL).  Both cases were treated by termination of pregnancy by means of caesarean section after being transfused with fresh frozen plasma and platelets.  After delivery, the mothers were counseled regarding the prognosis, the causes, and the chance of recurrence in future pregnancy.  The prognosis of repeating HELLP syndrome in next pregnancy is 19-27 percent.  The primary objective in the management of HELLP syndrome is to save the mother.  The neonatal morbidity and mortality depends on the gestational age at the time of development of HELLP syndrome.

Key words:      pregnancy-induced hypertension, HELLP syndrome