A 28-year-old woman is diagnosed with HELLP syndrome at 31 weeks. Her platelet count is 52,000/µL. She is hemodynamically stable with no active bleeding. Betamethasone has been administered. After 24 hours, her platelet count is 38,000/µL and rising liver enzymes plateau. According to ACOG guidelines, which of the following is the recommended gestational age threshold for delivery in HELLP syndrome with stable maternal-fetal condition?
- A Immediate delivery regardless of gestational age
- B 34 weeks ✓
- C 37 weeks
- D Expectant management until spontaneous labor
Correct answer: B. 34 weeks
Explanation
ACOG recommends delivery of pregnancies with HELLP syndrome at or beyond 34 weeks after completion of corticosteroids for fetal lung maturity. Before 34 weeks, expectant management with corticosteroids may be considered only in selected stable patients at tertiary centers. Expectant management beyond 34 weeks is not recommended as maternal condition can deteriorate rapidly. Immediate delivery regardless of gestational age is reserved for DIC, placental abruption, or non-reassuring fetal status.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.