In a patient with HELLP syndrome, the Stanford classification uses LDH, AST and platelet count. Which laboratory finding correctly identifies Class 1 (most severe) HELLP by the Tennessee classification?
- A Platelets < 50,000/µL, LDH ≥ 600 IU/L, AST ≥ 70 IU/L ✓
- B Platelets 50,000–100,000/µL, LDH ≥ 600 IU/L
- C Platelets 100,000–150,000/µL, LDH ≥ 600 IU/L
- D Platelets < 100,000/µL, bilirubin > 1.2 mg/dL only
Correct answer: A. Platelets < 50,000/µL, LDH ≥ 600 IU/L, AST ≥ 70 IU/L
Explanation
The Tennessee (Sibai) classification divides HELLP into complete (all three criteria: LDH ≥ 600, AST ≥ 70, platelets < 100,000) and partial. The Mississippi classification further grades into Class 1 (platelets < 50,000, LDH ≥ 600, AST ≥ 70), Class 2 (platelets 50,000–100,000), and Class 3 (platelets 100,000–150,000); Class 1 has the worst prognosis. Option B describes Class 2 and option C describes Class 3.
Reference: Williams Obstetrics, 26th ed.
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