A 28-year-old primigravida at 34 weeks has BP 155/105 mmHg, proteinuria 2+, and thrombocytopenia (platelets 90,000/µL) with elevated AST. HELLP syndrome is diagnosed. According to the classification by Sibai (Tennessee classification), this patient would be classified as:
- A Class I HELLP (platelets <50,000/µL)
- B Class II HELLP (platelets 50,000–100,000/µL) ✓
- C Class III HELLP (platelets 100,000–150,000/µL)
- D Partial HELLP (Mississippi classification)
Correct answer: B. Class II HELLP (platelets 50,000–100,000/µL)
Explanation
The Tennessee classification by Sibai classifies HELLP by platelet count: Class I (<50,000/µL), Class II (50,000–100,000/µL), Class III (100,000–150,000/µL). With platelets of 90,000/µL, this patient falls into Class II. The Mississippi classification uses different criteria with three classes based on platelet nadir and LDH. Class I carries the worst prognosis with highest risk of DIC, abruption, and maternal mortality. Management at 34 weeks with Class II HELLP is delivery after steroid administration and stabilization.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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