Abstract
Idiopathic thrombocytopenic purpura (ITP) with HELLP represents a rare complication that requires combined care of obstetrician, anesthesiologist, hematologist, and neonatologist. At 37-week gestation a 35-year-old parturient (G2A1P0) a known case of chronic ITP presented with severe pregnancy induced hypertension (PIH), thrombocytopenia, and elevated liver enzymes. We describe successful anesthetic management of this patient who was taken for emergency caesarean section.
Highlights
The concomitance of chronic Idiopathic thrombocytopenic purpura (ITP), preeclampsia-eclampsia syndrome, and HELLP syndrome in a parturient is not very well described in literature
We describe the anesthetic management of a patient of chronic ITP who develops preeclampsia syndrome with HELLP syndrome
She had thrombocytopenia and her bone marrow biopsy revealed normocellular marrow with megakaryocytes. She received methylprednisolone (20 mg/day) for 6 months which was later tapered down. She was on regular antenatal care (ANC) and did not receive any treatment during pregnancy as she had mild thrombocytopenia and her platelets remained around 100–150 × 109/L
Summary
The concomitance of chronic ITP, preeclampsia-eclampsia syndrome, and HELLP syndrome in a parturient is not very well described in literature. We describe the anesthetic management of a patient of chronic ITP who develops preeclampsia syndrome with HELLP syndrome
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