HELLP Syndrome in a Pregnant Woman: A Case Report

Abstract

Introduction: HELLP syndrome is a severe complication of hypertensive pregnancy disorders. This report describes a case of postpartum-onset HELLP syndrome with atypical presentation.

Patient concerns: A 42-year-old pregnant woman at 36 weeks presented with severe hypertension (180/109 mmHg). HELLP syndrome was diagnosed postoperatively based on laboratory findings: elevated liver enzymes (AST 1394.7 IU/L, ALT 667.5 IU/L), high LDH (2517.1 U/L), and low platelets (35 × 10⁹/L). The patient showed tea-colored urine, indicating hemolysis.

Diagnosis: HELLP syndrome.

Interventions: Management included magnesium sulfate for seizure prophylaxis, urapidil and nicardipine for blood pressure control, liver protection therapy, and corticosteroids.

Outcomes: After 4 days of ICU care, the patient's condition stabilized with improved laboratory parameters.

Clinical significance: HELLP syndrome can develop postpartum and requires vigilant monitoring and multidisciplinary management.

Abbreviations: HELLP syndrome = hemolysis, elevated liver enzymes and low platelets count syndrome

Keywords: HELLP syndrome; Postpartum; Case report; Hypertension; Pregnancy complications