Document Type : Case Report


1 Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 Emergency Medicine Department, Maragheh University of Medical Sciences, Maragheh, Iran

3 Genecology and Reproductive Department, Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran


 The first time Weinstein in 1982 described patients with the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP) in pregnant preeclamptic and eclamptic patients. This syndrome is a severe form of preeclampsia or eclampsia. Usually HELLP syndrome occurs at the third trimester and only 15% occur before the 27th week of pregnancy and rarely before the 20th week of pregnancy. We want to present a 30- year old parity 2, gravidity 1 pregnant patient who was pregnant for 20 weeks with preeclampsia and HELLP syndrome. Two hours before arriving to the emergency unit, she felt chest discomfort and went to the nearest clinic to visit a physician. She was then referred to the hospital because of high blood pressure (BP). When she arrived to the emergency unit, she had right upper quadrant and epigastric pain, headache, vomiting, dyspnea, and high BP (185/100). Finally the diagnosis of HELLP syndrome was made. As maternal and fetus mortality and morbidity of HELLP syndrome is high, immediate recognition and treatment is vital to save the lives of both the mother and the fetus.


Main Subjects

1. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982; 142(2): 159 -67.
2. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol 1993; 169(4): 1000-6.
3. Curtin WM, Weinstein L. A review of HELLP syndrome. J Perinatol 1999; 19(2): 138-43.
4. Pawelec M, Karmowski A, Karmowski M, Krzemieniewska J, Kulczycka A, Gabryś MS, et al. Inability to have children caused by recurrent HELLP
syndrome in early pregnancies - implications for a review of literature. Adv Clin Exp Med2013; 22(5): 753-8.
5. Martin JN Jr, Rose CH, Briery CM. Understanding and managing HELLP syndrome: the integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol 2006; 195(4): 914-34.
6. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol 2004; 103(5): 981-91.
7. Yıldırım G, Güngördük K, Aslan H, Gül A, Bayraktar M, Ceylan Y. Comparison of perinatal and maternal outcomes of severe preeclampsia, eclampsia, and HELLP syndrome. J Turk Ger Gynecol Assoc2011; 12(2): 90-6. doi: 10.5152/jtgga.2011.22