A 32-year-old G2P1 at 30 weeks presents with BP 170/112, epigastric pain, AST 120 U/L, platelet count 88,000/μL, and haemoglobin 9.2 g/dL. Peripheral smear shows schistocytes. Which named syndrome does this represent and what is the definitive treatment?
- A HELLP syndrome; delivery is the definitive treatment regardless of gestational age ✓
- B AFLP; fresh frozen plasma and supportive care
- C HELLP syndrome; corticosteroids to improve platelet count before planned delivery at 48 hours
- D TTP-HUS; plasmapheresis is the treatment of choice
Correct answer: A. HELLP syndrome; delivery is the definitive treatment regardless of gestational age
Explanation
The triad of haemolysis (schistocytes, low Hb), elevated liver enzymes (AST 120), and low platelets (<100,000) defines HELLP syndrome, a severe variant of pre-eclampsia. While corticosteroids may transiently improve platelet counts, the definitive treatment is delivery, which should not be delayed regardless of gestational age in confirmed HELLP. TTP-HUS lacks hypertension and liver involvement; AFLP shows coagulopathy with hypoglycaemia.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.