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To the Editor: Dr Stone¹ presented a typical case of the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) that occurred in his wife. After she gave birth her condition continued to deteriorate to the point that she required aggressive medical therapy. Our data on the relationship between thrombocytopenia and the HELLP syndrome² suggest that monitoring the platelet count before delivery may help to identify women at an increased risk of this syndrome and, thus, help to avoid the risk of serious complications and the need for aggressive therapy postnatally.

It is not known whether the thrombocytopenia results from the HELLP syndrome or whether it precedes it. However, we recently found that 22 (3.7%) of the 592 women with uncomplicated singleton pregnancies exhibit a gradual decline in the antenatal platelet count to less than 150 x 10⁹/L.³ The women with thrombocytopenia were 7.4 times more likely . . . [Full Text of this Article]

RELATED ARTICLE

HELLP Syndrome: Hemolysis, Elevated Liver Enzymes, and Low Platelets
John H. Stone
JAMA. 1998;280(6):559-562.
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