A 30-year-old primigravida at 28 weeks has BP 154/102 mmHg, proteinuria 2+, platelets 95,000/µL, and AST 80 U/L. She is diagnosed with HELLP syndrome. Which of the following findings is an indication for immediate delivery regardless of gestational age?
- A Disseminated intravascular coagulation with active bleeding ✓
- B AST 80 U/L
- C Platelet count 95,000/µL
- D Gestational age of 28 weeks
Correct answer: A. Disseminated intravascular coagulation with active bleeding
Explanation
DIC with active bleeding is an absolute indication for immediate delivery in HELLP syndrome regardless of gestational age, as it represents life-threatening maternal compromise. Platelets above 50,000/µL and elevated but stable transaminases alone do not mandate immediate delivery if the mother can be stabilized. Gestational age of 28 weeks alone is not an absolute indication for immediate delivery if the mother is stable, as corticosteroids can be given for fetal lung maturity.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.