ABSTRACT
OBJECTIVE: To present a case of death of a patient with fulminant course of HELLP syndrome in 32nd week of pregnancy. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Hospital Kladno. CASE REPORT: We report a case of 29 years old primigravida in 32nd week of pregnancy, which was admitted to the hospital in a serious condition with cephalea, vomiting and progressive full-body swelling. During the entrance examination the patient looses consciousness, due to critical pressure an emergency caesarian section is performed. Laboratory values correspond to a fully developed HELLP syndrome, which gradually progresses from class III to class I of Mississippi classification. The patient´s condition required further surgical interventions including hysterectomy. Despite intensive therapy and multidisciplinary cooperation a gradual failure of vital functions and death of the patient followed. CONCLUSION: Presenting this critical situation the authors want to emphasize the need of early diagnosis and subsequent comprehensive treatment in cooperation with other disciplines in the care of critically endangered patient on delivery room.
Subject(s)
HELLP Syndrome/diagnosis , Pregnancy Complications/diagnosis , Acute Disease , Adult , Cesarean Section , Diagnosis, Differential , Fatal Outcome , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy OutcomeABSTRACT
Placenta accreta is a diagnosis, which will gynecologists have to face probably more often, than in previous years. The reason is the increasing number of cesarean sections, one of the most important risk factors. The following case shows, that a placenta accreta not treated primary by hysterectomy, can have consequences even after a longer period. This time the manifestation was a severe bleeding one year after the delivery per cesarean section, which had to be treated by an acute hysterectomy.
