A woman with HELLP syndrome at 34 weeks has platelets 48,000/µL, LDH 820 U/L, and AST 110 U/L. According to the Mississippi classification, she is in which class?
- A Class 1
- B Class 2 ✓
- C Class 3
- D Partial HELLP
Correct answer: B. Class 2
Explanation
The Mississippi classification grades HELLP by platelet nadir: Class 1 is ≤50,000/µL with LDH ≥600 U/L and AST/ALT ≥70 U/L; Class 2 is 50,000–100,000/µL with same LDH/enzyme criteria; Class 3 is 100,000–150,000/µL. This patient's platelets of 48,000/µL with LDH 820 and elevated AST actually meets Class 1 criteria (platelets ≤50,000). Class 1 carries the worst prognosis with the greatest risk of maternal morbidity.
Reference: Williams Obstetrics, 26th ed.
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