INTRACEREBRAL HEMORRHAGE AS COMPLICATION IN HELLP-SYNDROME

The HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a severe, life-threatening variant of EPH gestosis with a maternal mortality of 3.1%. Intracerebral haemorrhage occurs in 3,7% of the cas es. We report on two primigravidae in whom the clinical courses differ ed. In one patient a grand mal seizure and acute upper abdominal pain and vomiting made Caesarean section mandatory. The other patient had a grand mal seizure after Caesarean delivery. In both patients low thro mbocyte counts, elevated liver enzymes, and haemolysis indicated a HEL LP-syndrome. CT-scanning demonstrated intracerebral haemorrhages. One patient recovered completely after 33 days, the other developed genera l brain oedema with diencephalic herniation. The high risk of HELLP sy ndrome and the difficult prediction of its course demand both intensiv e postpartal monitoring and interdisciplinary intensive-care therapy.