A 30-year-old primigravida at 34 weeks presents with BP 158/108 mmHg on two occasions 4 hours apart. Her platelet count is 88,000/µL, AST is 98 U/L, and she complains of severe epigastric pain. Which component of the HELLP syndrome is she MISSING to fulfill the complete laboratory triad?
- A Elevated liver enzymes
- B Hemolysis (microangiopathic) ✓
- C Low platelets
- D Elevated serum creatinine
Correct answer: B. Hemolysis (microangiopathic)
Explanation
The HELLP syndrome triad requires Hemolysis (H — abnormal peripheral smear, LDH >600 U/L, total bilirubin >1.2 mg/dL), Elevated Liver enzymes (EL — AST >70 U/L), and Low Platelets (LP — <100,000/µL). This patient has elevated AST (EL) and platelets <100,000 (LP) but no mention of microangiopathic hemolytic anemia, so Hemolysis is the missing component. Serum creatinine elevation is not part of the Tennessee Classification triad for HELLP.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.