3.HELLPSyndromea.Presentation:Symptomsare oftennonspecificalaise, abdominal pain, vomiting, shortness ofbreath, bleeding.b.Differentialdiagnosis:Becauseofpresentation, HELLP syndrome must bedifferentiated from other disorders
a. Presentation: Symptoms are often nonspecific alaise, abdominal pain, vomiting, shortness of breath, bleeding. b. Differential diagnosis: Because of presentation, HELLP syndrome must be differentiated from other disorders
C.Management is the same as for severe pre-eclampsiaDelivery ata Perinatal CenterIf the only presenting symptom is thrombocytopenia,without elevated levels on liverfunction tests,antepartum treatment with steroids may be used toencourage platelet production but should be restrictedtolessthan28weeks'gestation
C.Management is the same as for severe pre-eclampsia. Delivery at a Perinatal Center If the only presenting symptom is thrombocytopenia, without elevated levels on liver function tests, antepartum treatment with steroids may be used to encourage platelet production but should be restricted to less than 28 weeks' gestation
Dosageis 10mg intramuscular/intravenous (IV)dexamethasone every12hours until platelets exceed100,000/mm3.If no response is seen by 24 to48hours or the patient's condition worsens,the patientshould bedelivered.Postpartum patients withthrombocytopenia maybesimilarlytreated with dexamethasone.The average time for resolution of symptoms is 4 days
Dosage is 10 mg intramuscular/intravenous (IV) dexamethasone every 12 hours until platelets exceed 100,000/mm3. If no response is seen by 24 to 48 hours or the patient's condition worsens, the patient should be delivered. Postpartum patients with thrombocytopenia may be similarly treated with dexamethasone. The average time for resolution of symptoms is 4 days
4.Seizureprophylaxis duringlabor and for 24hours postpartum is recommended for allpatients with pre-eclampsia. Some patients withseverepre-eclampsia need seizureprophylaxisfor longer periods before and after delivery
4. Seizure prophylaxis during labor and for 24 hours postpartum is recommended for all patients with pre-eclampsia. Some patients with severe pre-eclampsia need seizure prophylaxis for longer periods before and after delivery
a.Magnesium Sulfate (MgSO4)agent of Choicefor Seizure Prophylaxis.Magnesium sulfate hasbeen shown to decrease the risk of progressiontoeclampsiabygreaterthan50% (15).Loading dose is 6 g IV administered over 15 to20minutes.Maintenance dosage is 2g/hr IV and may betitrated to higher doses
a. Magnesium Sulfate (MgSO4) agent of Choice for Seizure Prophylaxis. Magnesium sulfate has been shown to decrease the risk of progression to eclampsia by greater than 50% (15). Loading dose is 6 g IV administered over 15 to 20 minutes. Maintenance dosage is 2 g/hr IV and may be titrated to higher doses