A 28-year-old primigravida at 34 weeks develops BP 158/106 mmHg, proteinuria 3+, and serum creatinine 1.4 mg/dL. Platelet count is 68,000/mm³ and LDH is 720 U/L. Which feature specifically identifies HELLP syndrome as a complication of severe pre-eclampsia in this patient?
- A Serum creatinine exceeding 1.1 mg/dL
- B Diastolic BP above 110 mmHg on two occasions
- C Platelet count below 100,000/mm³ with hemolysis and elevated liver enzymes ✓
- D Proteinuria exceeding 5 g in 24 hours
Correct answer: C. Platelet count below 100,000/mm³ with hemolysis and elevated liver enzymes
Explanation
HELLP syndrome is defined by the triad of Hemolysis (microangiopathic hemolytic anemia, elevated LDH), Elevated Liver enzymes (AST/ALT), and Low Platelets (below 100,000/mm³). This patient's thrombocytopenia and elevated LDH fulfil the diagnostic criteria. Elevated creatinine and diastolic hypertension are features of severe pre-eclampsia but not specific to HELLP; heavy proteinuria characterises severe proteinuric pre-eclampsia.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.