Severe early onset hemolysis, elevated liver enzyme, and low platelet-syndrome in 2 subsequent pregnancies: case report and review of the literature

Abstract

Pregnancies after a previous pregnancy complicated by hemolysis, elevated liver enzyme, and low platelet (HELLP) syndrome carry an increased risk of HELLP-syndrome. We report on a 35-year-old patient with both HELLP-syndrome and fatal neonatal outcome in two subsequent pregnancies with delivery by cesarean section in the 26th and 27th gestational weeks, respectively. The children were immediately admitted to the neonatal intensive care unit but died in their postpartum period. Before the second pregnancy testing for antiphospholipid-syndrome revealed normal results. In general, pregnancies after HELLP-syndrome carry increased risks for pregnancy-related complications. Evaluation of the immunologic status and application of immune-globulins could be diagnostic and therapeutic options in our case. Further research is recommended to evaluate the mechanisms of recurrence of HELLP-syndrome.