Management of HELLP Syndrome with ARDS in a Primigravida: A Case Report

Abstract

HELLP syndrome, characterized by hemolysis, elevated liver enzymes, and low platelets, is a severe complication of pregnancy often associated with preeclampsia and eclampsia. We report a case of a 32-year-old primigravida who presented with HELLP syndrome and seizures at 35 weeks of gestation, necessitating emergent cesarean delivery. Postoperatively, the patient developed acute respiratory distress syndrome (ARDS), requiring prolonged intensive care management. Laboratory findings revealed hemolytic anemia, elevated liver enzymes, thrombocytopenia, and acute kidney injury. The patient was managed with mechanical ventilation, intravenous fluids, antihypertensives, corticosteroids, and platelet transfusions. Over six weeks, the patient's respiratory and renal functions normalized, and she was discharged in stable condition. The neonate also recovered well without significant complications. This case underscores the importance of early recognition and aggressive management of HELLP syndrome to prevent severe maternal and fetal complications. The development of ARDS as a complication highlights the need for a multidisciplinary approach in managing such cases.