A 29-year-old primigravida at 34 weeks gestation has BP 158/106 mmHg, proteinuria 2+ on dipstick, and complains of epigastric pain. Platelet count is 88,000/µL, AST 210 IU/L, LDH 680 IU/L. Her serum creatinine is 1.3 mg/dL. Which of the following criteria BEST classifies this patient's condition?
- A HELLP syndrome with severe features of pre-eclampsia ✓
- B Severe pre-eclampsia due to serum creatinine >1.1 mg/dL
- C Gestational hypertension with superimposed hepatic involvement
- D Eclampsia with subclinical hepatic involvement
Correct answer: A. HELLP syndrome with severe features of pre-eclampsia
Explanation
This patient meets criteria for HELLP syndrome: Hemolysis (elevated LDH), Elevated Liver enzymes (AST 210), and Low Platelets (<100,000/µL). She also has severe features of pre-eclampsia (BP ≥160/110, creatinine >1.1, epigastric pain). HELLP is a severe variant of pre-eclampsia and the two diagnoses coexist. Eclampsia requires convulsions, which are not described here.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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