Pregnancy Complicated by HELLP Syndrome in a Patient with Morbid Obesity

Daniel Boron* and Ewa Wender-Ozegowska

Department of Reproduction, Poznań University of Medical Sciences, Poland

^*Correspondance to: Daniel Boron 

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Abstract:

Hemolysis, Elevated Liver enzymes, and Low Platelets count (HELLP) syndrome is a severe pregnancy complication associated with an impaired placental function. Rapid progression and non-specific symptoms render a definitive diagnosis exceptionally challenging. However, in spite of the fact that there is no specific treatment for HELLP syndrome, the delivery appears to be beneficial both for the fetus and the mother. Our paper presents a case of a woman who developed HELLP syndrome at the 31st week of gestation. On admission, the pregnancy had already been complicated by gestational diabetes mellitus, thirddegree obesity, and uncertain gestational age. Due to the BMI equal to 63.48 kg/m2 (weight 162.5 kg height 1.6 m), cardiotocography was impossible, and the range of the ultrasound examination was limited. It is vital to note that in this case two pathologies were observed, which affected both the fetus and the mother. Initially, the patient presented with gestational diabetes which resulted in maternal hyperglycemia and excessive fetal growth. Furthermore, secondary placental insufficiency developed which manifested as HELLP syndrome. In turn, impaired placental function reduced maternal glucose levels due to inadequate insulinase activity and restricted the fetal growth. Therefore, establishing the diagnosis entailed the understanding of the two co-existing antagonist effects, concealing the potential symptoms of the disease. The treatment involved corticosteroids to manage fetal maturation as well as timely delivery. Cesarean section due to the fetal distress was performed in the 31st week of gestation-neonatal weight was 1360 g, and Apgar scores were 7,7,8,8. The neonate in good condition was discharged on the 41st day following the cesarean section. Our case confirmed the relevance of liver and placental impairment biomarkers in HELLP syndrome diagnosis, particularly in view of the limited diagnostic tools in patients with obesity.

Keywords:

HELLP syndrome; Obesity; Morbid obesity; Preterm delivery

Cite the Article:

Boron D, Wender-Ozegowska E. Pregnancy Complicated by HELLP Syndrome in a Patient with Morbid Obesity. Ann Clin Case Rep. 2022; 7: 2184..