Fetomaternal outcome in pregnancy with HELLP syndrome

Background: HELLP Syndrome is a serious complication of pregnancy induced hypertensive disorders. It is defined as a triad of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Objectives of this study was to find out incidence of HELLP syndrome in pre-eclampsia, eclampsia and its overall incidence. To analyse the clinical profile of HELLP syndrome. To study maternal and perinatal outcome including morbidity and mortality.Methods: A retrospective study was conducted from July 2017 to September 2019 at a tertiary care center with inclusion criteria of abnormal peripheral blood smear, elevated liver enzymes (LDH, aspartate aminotransferase), and low platelet count.Results: HELLP syndrome was more common in younger age group (45%) and in primigravida (52.5%). Most of the patients presented at >36 weeks of gestation (40%) and most of the patients delivered by caesarean section (67.5%). Maternal complications were acute renal failure (27.5%), DIC (22.5%), maternal mortality (7.5%). Neonatal complications associated were intrauterine death (27.5%), prematurity (25%) and intrauterine growth retardation (15%).Conclusions: Thus, HELLP syndrome requires an early diagnosis and early initiation of treatment at tertiary care center with all the medical facilities available.

Study of thrombocytopenia in pregnancy: clinical presentation and outcome at tertiary care rural institute

Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes.

A Rare Case of Tamoxifen-Induced Thrombocytopenia.

Breast cancer is a commonly encountered cancer in women. Tamoxifen is a frequently used drug in breast cancer. It is a selective estrogen receptor modulator (SERM). It is used for both chemoprevention and for palliative care in these patients. Drug-induced thrombocytopenia is a common diagnosis these days. Moreover, this condition can be life threatening or even fatal. It can either be due to increased platelet destruction or reduced formation. Either way, early diagnosis followed by discontinuation of the offending agent is the key to successful management. Here, we present a rare case of tamoxifen-induced thrombocytopenia

Síndrome de encefalopatía reversible posterior (PRES) asociada a eclampsia y síndrome HELLP / Posterior reversible encephalopathy syndrome (PRES) associated with eclampsia and HELLP syndrome

Es un síndrome usualmente reversible consistente en cefalea, alteración del estado mental, convulsiones y pérdida de la visión, asociado a edema cerebral de localización predominantemente posterior en estudios de imagen (1). La falta de su reconocimiento y manejo temprano puede ocasionar daños neurológicos permanentes (2). Se presenta el caso de una paciente de 29 años con 36 semanas de edad gestacional que ingresa al servicio de urgencias en estado epiléptico por eclampsia, síndrome HELLP (Hemólisis, Enzimas hepáticas elevadas, Plaquetas bajas) e imágenes hipodensas en regiones occipital y frontal en Tomografía Axial Computarizada de cráneo.

This syndrome, usually reversible, consists in symptoms like headache, altered mental status, seizures and lost of sight, associated to brain edema predominantly in posterior cerebral regions. The lack of its recognition and early management can lead to permanent neurological damage. It is presented the case of a 29 - year - old patient with 36 weeks of gestational age who arrives to the emergency room in epileptic status. She was diagnosed with eclampsia, HELLP (Hemolysis, elevated liver enzymes, low platelets) syndrome and occipital hypodense images were determined by cerebral Computarized Tomography.