SAQ 155 – Obstetrics – HELLP syndrome

A 29 year old woman who is 30 weeks pregnant presents to the emergency department with a two day history of nausea and RUQ discomfort.

Her observations are: GCS 15, HR 95/min, BP 150/100 mmHg, temperature 36.5 C, oxygen saturation 97% on room air.

Initial investigations are shown below.

Test	Result	Units	Reference range
Sodium	139	mmol/L	135-145
Potassium	4.1	mmol/L	3.5-5.1
Chloride	105	mmol/L	99-109
Bicarbonate	21	mmol/L	21-32
Urea	8.0	mmol/L	2.5-6.7
Creatinine	48	micromol/L	30-120
Glucose	4.3	mmol/L	3.0-6.0
Total protein	60	g/L	60-80
Albumin	35	g/L	35-50
Bilirubin	33	micromol/L	5-17
ALP	225	IU/L	40-120
AST	5418	IU/L	10-36
Hb	11.4	g/dL	11.5-14.5
WCC	6.7	10^9/L	3.6-10.5
Platelets	72	10^12/L	150-400
INR	1.4		1.0-1.2
APTT	28	secs	24-35

State the diagnosis for her clinical state and blood results.

(Marked out of 2.0)

/ 2

Analgesic and antiemetics are provided. List three (3) key treatment steps in the first 1 hour of your care.

(Marked out of 3.0)

/ 3

List three (3) examination findings that would suggest imminent deterioration for this patient.

(Marked out of 3.0)

/ 3

List four (4) key treatment steps that may be required if this condition was to deteriorate.

(Marked out of 4.0)

/ 4

Total Score: 0 / 12

Percentage: 0%