HELLP Syndrome: Managing This Obstetric Emergency скачать в хорошем качестве

HELLP Syndrome: Managing This Obstetric Emergency

✅Subscribe Doctor Why on Telegram - https://t.me/doctorwhymed_bot (press start, and choose your plan) A 32-year-old primigravida at 34 weeks gestation presents to the emergency department with a 3-day history of progressively worsening severe epigastric pain, nausea, and vomiting. She reports a dull, persistent headache that has not responded to acetaminophen. Her blood pressure is 165/105 mmHg. Physical examination reveals right upper quadrant tenderness. Laboratory results show: hemoglobin 9.8 g/dL (reference 12-16 g/dL), platelet count 85,000/µL (reference 150,000-450,000/µL), AST 120 U/L (reference 10-40 U/L), ALT 150 U/L (reference 7-56 U/L), and LDH 800 U/L (reference 100-250 U/L). Urinalysis shows 2+ proteinuria. Which of the following is the most appropriate immediate next step in managing this patient? A. Initiate intravenous labetalol for blood pressure control and schedule for outpatient follow-up. B. Administer a bolus of intravenous fluids and broad-spectrum antibiotics for suspected pyelonephritis. C. Initiate magnesium sulfate for seizure prophylaxis and prepare for delivery. D. Perform a non-stress test and advise rest with close monitoring at home. === Correct Answer: C The patient presents with classic signs and symptoms of HELLP syndrome, a severe variant of preeclampsia. Her elevated blood pressure (165/105 mmHg), severe epigastric pain with right upper quadrant tenderness, headache, and laboratory abnormalities (hemolysis indicated by low hemoglobin and elevated LDH, elevated liver enzymes, and thrombocytopenia) are all consistent with HELLP. The most critical immediate management involves stabilization and preparation for delivery, often requiring magnesium sulfate for seizure prophylaxis due to the high risk of eclampsia. Outpatient management or treatment for other conditions would be inappropriate given the severity and urgency of HELLP syndrome.. #hellp #pregnancy #toxicity Professor Armen Astvatsatryan, MD, PhD, ScD, Fellow of European Society of Cardiology. First Dean and Founder of Faculty of Public Health of European Regional Educational Academy (now University). One of 100 Top Health Professionals - 2007 by the International Biographical Center`s (Cambridge, England) [email protected]   / armenastvatsatryan