HELLP SYNDROME IN CLINICAL PRACTICE (CLINICAL CASE)

Abstract

Introduction. The frequency of this pathology is 0.5-0.9%, and up to 10-20% in severe preeclampsia and eclampsia. In 70% of cases, it develops during pregnancy (up to 27 weeks – 10%, 27-37 weeks –
50%, after 37 weeks – 20%). In 30% of cases, the syndrome manifests itself within 48 hours after labour.
Objective of the study. To present the dynamics of clinical indicators of liver and kidney functions in multiple pregnancies. To identify the advantage of managing HELLP syndrome according to the protocol of the Ministry of Healthcare of the Republic of Kazakhstan.
Methods. Monitoring the liver function indicators over time (platelets, ALT (alanine aminotransferase), AST (aspartate aminotransferase), total bilirubin). Liver ultrasound examination. Dopplerography of the uterine vessels in color mapping mode.
Results. This group of patients should be monitored in the intensive care unit in the presence of clinical symptoms.
Conclusions. Strict monitoring of coagulopathic parameters such as platelets, INR (international normalized ratio), PT (prothrombin time), PTI (prothrombin index), Fibrinogen, APTT (active partial thromboplastin time), D-dimer is necessary in the early stages of pregnancy.
A decrease in one of the indicators is a predictor of the development of HELLP syndrome during pregnancy, which aggravates its severity and course. Early delivery is required to avoid maternal mortality, since the incidence of maternal mortality reaches 20%, and perinatal mortality – 7.9%.