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Obstetric Anaesthesia

Anaesthetic management of HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)

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Hupuczi, P.; Rigo, B.; Szabo, G.

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European Journal of Anaesthesiology (EJA): June 2006 - Volume 23 - Issue - p 181
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Background and Goal of Study: HELLP syndrome is a life-threatening complication of pregnancy characterized by hemolysis, elevated liver enzymes and low platelets, first described by Weinstein in 1982 (1). Spinal anaesthesia may be safely administered in patients with HELLP syndrome, without coagulopathy (2). The aim of our study was to analyze the mode of anaesthesia applied at the cesarean section of HELLP patients.

Materials and Methods: We treated 107 patients with HELLP syndrome at the I. Dept. Ob/Gyn., Semmelweis University between 1995 and 2004. Cesarean section was performed in 103 cases. The anaesthesia was spinal in 38 cases (37%) and general in 65 cases (63%).

Results and Discussions: The main age of the patients was 29 years, mean gestational age was 31 weeks. The lowest platelet count observed was 41.000/μl. The complications of anaesthesia are shown in the Table.

Table
Table:
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Conclusion(s): Our study supports the observation that spinal analgesia has advantages over intratracheal narcosis in the anaesthesia of HELLP syndrome.

References:

1 Weinstein L. Obstet Gynecol 1982; 142:159-167.
2 Vigil-De Gracia P. Int J Gynaecol Obstet 2001; 74:23-27.
© 2006 European Society of Anaesthesiology