Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review
Introduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (M...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2017/8481290 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560487047364608 |
|---|---|
| author | Shadi Rezai Justin Faye Alexander Hughes Mon-Lai Cheung Joel R. Cohen Judy A. Kaia Paul N. Fuller Cassandra E. Henderson |
| author_facet | Shadi Rezai Justin Faye Alexander Hughes Mon-Lai Cheung Joel R. Cohen Judy A. Kaia Paul N. Fuller Cassandra E. Henderson |
| author_sort | Shadi Rezai |
| collection | DOAJ |
| description | Introduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (MRI) and a multidisciplinary management approach are required to improve perinatal outcome. Case. A 37-year-old, Gravida 6, Para 1-0-4-1, Hispanic female with a history of chronic hypertension presented at 26 weeks and 6 days of gestational age. She was noted to have hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome accompanied by fetal growth restriction (FGR), during ultrasound evaluation, warranting premature delivery. The infant was delivered in stable condition suffering no permanent neurological deficit. Conclusion. HELLP syndrome is an uncommon and traumatic obstetric event which can lead to neurological deficits if not managed in a responsive and rapid manner. The central aggravating factor seems to be hypertension induced preeclamptic or eclamptic episode and complications thereof. The syndrome itself is manifested by hemolytic anemia, increased liver enzymes, and decreasing platelet counts with a majority of neurological defects resulting from hemorrhagic stroke or subarachnoid hemorrhage (SAH). To minimize adverse perinatal outcomes, obstetric management of this medical complication must include rapid clinical assessment, diagnostic examination, and neurosurgery consultation. |
| format | Article |
| id | doaj-art-b6647a70e58243f99164f753b0bdc2d4 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-b6647a70e58243f99164f753b0bdc2d42025-02-03T01:27:28ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922017-01-01201710.1155/2017/84812908481290Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic ReviewShadi Rezai0Justin Faye1Alexander Hughes2Mon-Lai Cheung3Joel R. Cohen4Judy A. Kaia5Paul N. Fuller6Cassandra E. Henderson7Department of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USASt. George’s University, School of Medicine, West Indies, GrenadaSt. George’s University, School of Medicine, West Indies, GrenadaDepartment of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USADepartment of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USADepartment of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USADepartment of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USADepartment of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, 234 East 149th Street, Bronx, NY 10451, USAIntroduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (MRI) and a multidisciplinary management approach are required to improve perinatal outcome. Case. A 37-year-old, Gravida 6, Para 1-0-4-1, Hispanic female with a history of chronic hypertension presented at 26 weeks and 6 days of gestational age. She was noted to have hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome accompanied by fetal growth restriction (FGR), during ultrasound evaluation, warranting premature delivery. The infant was delivered in stable condition suffering no permanent neurological deficit. Conclusion. HELLP syndrome is an uncommon and traumatic obstetric event which can lead to neurological deficits if not managed in a responsive and rapid manner. The central aggravating factor seems to be hypertension induced preeclamptic or eclamptic episode and complications thereof. The syndrome itself is manifested by hemolytic anemia, increased liver enzymes, and decreasing platelet counts with a majority of neurological defects resulting from hemorrhagic stroke or subarachnoid hemorrhage (SAH). To minimize adverse perinatal outcomes, obstetric management of this medical complication must include rapid clinical assessment, diagnostic examination, and neurosurgery consultation.http://dx.doi.org/10.1155/2017/8481290 |
| spellingShingle | Shadi Rezai Justin Faye Alexander Hughes Mon-Lai Cheung Joel R. Cohen Judy A. Kaia Paul N. Fuller Cassandra E. Henderson Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review Case Reports in Obstetrics and Gynecology |
| title | Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review |
| title_full | Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review |
| title_fullStr | Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review |
| title_full_unstemmed | Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review |
| title_short | Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review |
| title_sort | hemolysis elevated liver enzymes and low platelets severe fetal growth restriction postpartum subarachnoid hemorrhage and craniotomy a rare case report and systematic review |
| url | http://dx.doi.org/10.1155/2017/8481290 |
| work_keys_str_mv | AT shadirezai hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT justinfaye hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT alexanderhughes hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT monlaicheung hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT joelrcohen hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT judyakaia hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT paulnfuller hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview AT cassandraehenderson hemolysiselevatedliverenzymesandlowplateletsseverefetalgrowthrestrictionpostpartumsubarachnoidhemorrhageandcraniotomyararecasereportandsystematicreview |