A 34-year-old primigravida presents with severe continuous lower abdominal pain and vaginal bleeding at 37 weeks gestation. Complete blood count reveals progressive thrombocytopenia (platelets 60,000/mm3), elevated AST (240 U/L), and elevated LDH (800 U/L) with schistocytes on peripheral blood smear. What variant of severe preeclampsia is present?

Answer and explanation

Correct answer: C. HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets)

  1. Step 1: HELLP syndrome is a severe complication of preeclampsia characterized by microangiopathic hemolytic anemia (Hemolysis), hepatic sinusoidal injury (Elevated Liver enzymes), and consumption coagulopathy (Low Platelets).
  2. Step 2: It carries substantial risk of hepatic infarction, subcapsular hematoma, and maternal mortality.
  3. Step 3: Prompt delivery regardless of gestational age is the definitive treatment.
Answer
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets).

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