A primigravida at 37 weeks has BP 158/104 mmHg with headache. Urine protein/creatinine ratio is 0.32. She has thrombocytopenia (platelets 92,000), elevated AST (95 U/L), and serum creatinine 1.2 mg/dL. This constellation best represents:

• A Severe HELLP syndrome, Class I
• B Severe pre-eclampsia with severe features, without complete HELLP
• C Antiphospholipid syndrome mimicking pre-eclampsia
• D Partial HELLP syndrome (Mississippi Classification Class II) ✓

Explanation

The Mississippi Classification of HELLP syndrome defines severity by platelet count: Class I (<50,000/mm³), Class II (50,000-100,000/mm³), Class III (100,000-150,000/mm³). This patient has platelets of 92,000 placing her in Class II. Complete HELLP (hemolysis + elevated liver enzymes + low platelets) requires LDH >600 U/L and peripheral smear showing hemolysis. The term 'partial HELLP' is used when not all three criteria are met. Tennessee Classification uses strict criteria requiring microangiopathic hemolysis, AST ≥70 U/L, and platelets <100,000.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.