Delivery and HELLP-syndrom

The laboratory findings of hemolysis, elevated liver enzymes and low platel ets are signs of an acute pregnancy complication often associated with abdo minal pain and intrauterine growth retardation. A high coincidence with sym ptoms of preeclampsia is observed. The high rate of complications and the r estitution of laboratory findings to normal values following cessation of p regnancy have led to the general recommendation of immediate delivery for a bout a decade. However, the fact that HELLP syndrome can also occur for up to 1 week post-partum and the results of studies on prolongation of pregnan cy call this former concept of management into question, in particular, sin ce there is a high rate of hemostasiological complications after cesarean s ection in acute HELLP syndrome. Because of the correlation of complications of HELLP syndrome with those of severe preeclampsia, the indication for de livery should be based on the signs of preeclampsia and additional clinical features. The results of studies on prolongation of pregnancies in HELLP s yndrome and severe preeclampsia support this concept.