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

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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: No Caption Available.

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