A Case Report : Atypical Presentation of HELLP Syndrome

Abstract

Atypical preeclampsia can rarely be found and is difficult to diagnose and the management might be late for a better outcome. Doctors have to diagnose when the disease is found in pregnant women present with signs and symptoms of preeclampsia and abnormal liver function test (LFT) in third trimester. By differential diagnosis of acute fatty liver, these signs and symptoms can be coincident about 50%. A nineteen years old pregnant patient with G₁P₀ GA 31 weeks presented with headache, high grade fever and abnormal LFT but had normal blood pressure. The final diagnosis was atypical preeclampsia and terminated pregnancy was by cesarean section. In postpartum, normal male preterm
newborn body weight 1,830 grams; APGAR score 9, 10, 10. The current screening and assessing the risk of reeclampsia in patients with risk factors has done by measuring the circulation of the blood vessels (uterine artery), which achieved in gestational age of 12 weeks and checking preeclampsia indicated substances, which include protein that promotes angiogenesis and protein that inhibits angiogenesis. Preeclampsia may present low level of protein that promotes angiogenesis and high level of protein that inhibits angiogenesis. These may help doctor to diagnose preeclampsia. Doctor can make follow up and care plan effectively or can differentiate diagnosis between HELLP syndrome and acute fatty liver.