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Volume 3, Issue 4 (Fall 2018)                   jogcr 2018, 3(4): 173-176 | Back to browse issues page

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Ayati S, Pourali L, Vatanchi A, Jedi L, Mohades Ardebili Z. Maternal Death Following Misdiagnosis of Emolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome: A Case Report and Review of Literature. jogcr. 2018; 3 (4) :173-176
URL: http://jogcr.com/article-1-180-en.html
Maternal Death Following Misdiagnosis of Emolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome: A Case Report and Review of Literature
Sedigheh Ayati1, Leila Pourali *2, Atiyeh Vatanchi1, Lida Jedi1, Zahra Mohades Ardebili3
1- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran , pouralil@mums.ac.ir
3- General Practitioner, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (147 Views)

Background & Objective: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count; it probably shows a severe form of preeclampsia. This syndrome usually occurs in third trimester of pregnancy and may be associated with severe complications, including subcapsular liver hematoma, eclampsia, pulmonary edema, liver or renal dysfunction, and even maternal death. This study aimed to report a case of maternal death misdiagnosis of HELLP syndrome.
Case Report: A 28-year-old pregnant woman with gestational age of 28 weeks referred to an emergency ward because of epigastric pain, nausea, and vomiting. She was discharged after receiving outpatient treatment. The next day, she was referred to the hospital because of seizure, decreased level of consciousness, and hypertension. A cesarean section was performed immediately. Unfortunately, some hours after the surgery, cardiac arrest occurred and she died in intensive care unit (ICU).
Conclusion: Nausea, vomiting, and epigastric pain in the late second or third trimester of pregnancy are among the significant symptoms which should be seriously taken into consideration. Therefore, it is recommended that a patient be hospitalized and precise evaluation be performed to rule out the life-threatening differential diagnoses, like HELLP syndrome, and to prevent dangerous complications which can lead to maternal death.

Keywords: HELLP syndrome, Pregnancy, Maternal death, Diagnosis
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✅ Nausea, vomiting, and epigastric pain in the late second or third trimester of pregnancy are among the significant symptoms which should be seriously taken into consideration. Therefore, it is recommended that a patient be hospitalized and precise evaluation be performed to rule out the life-threatening differential diagnoses, like HELLP syndrome, and to prevent dangerous complications which can lead to maternal death.


Systematic Review: Case Report | Subject: Obstetrics and Gynecology
Received: 2018/07/12 | Accepted: 2018/08/20 | Published: 2018/09/16
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