Case challenge · Obstetrics / Maternal-fetal medicine / Critical care · teaching

HELLP Syndrome — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on ACOG / Tennessee

Case #1Obstetrics / Maternal-fetal medicine / Critical care

📋 Case data

Immediate delivery needed?<34 weeks, maternal-fetal stable

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Immediate delivery needed?

Gestational age and maternal-fetal status — is immediate delivery needed?

💡 Hemolysis + raised liver enzymes + low platelets in pregnancy/postpartum, a severe pre-eclampsia variant; ~70% antepartum (mostly 27–37 weeks), the rest within 48 h postpartum. Tennessee (complete, all three): 1) hemolysis (schistocytes/LDH >600/bilirubin >1.2/haptoglobin <25); 2) AST (or ALT) ≥70 (>2× ULN); 3) platelets <100×10⁹. Mississippi grades by platelet nadir (class 1 <50k is most severe, with liver-rupture risk). RUQ/epigastric pain + nausea, may have no hypertension/proteinuria; complications DIC/abruption/subcapsular liver hematoma rupture/AKI.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.