A 30-year-old primigravida at 34 weeks presents with BP 160/110 mmHg, severe headache, and serum creatinine 1.3 mg/dL. Her 24-hour urine protein is 3.8 g. She has platelet count 82,000/mm³ and elevated LFTs. Which feature BEST identifies this as severe pre-eclampsia rather than HELLP syndrome?
- A Absence of microangiopathic haemolytic anaemia on peripheral smear ✓
- B Platelet count below 100,000/mm³
- C Elevated LFTs with right upper quadrant pain
- D Proteinuria above 3.5 g/24 hours
Correct answer: A. Absence of microangiopathic haemolytic anaemia on peripheral smear
Explanation
HELLP syndrome requires all three criteria: Haemolysis (microangiopathic haemolytic anaemia on smear with elevated LDH and bilirubin), Elevated Liver enzymes, and Low Platelets. Absence of haemolysis on peripheral smear excludes HELLP. Thrombocytopenia and elevated LFTs alone can be seen in severe pre-eclampsia without meeting full HELLP criteria.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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