Successful management of a pregnant woman with HELLP syndrome, pulmonary edema, postpartum hemorrhage and acute renal failure, using early hemodialysis, intravenous immunoglobulin and noninvasive monitoring: a case report.
BACKGROUND
HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) with medical complications is a major cause of maternal mortality in pregnancy. A vicious cycle may occur without expeditious delivery and proper management.


METHODS
A woman with severe HELLP syndrome, hemolytic renal failure, pulmonary edema and postpartum hemorrhage was successfully managed using early hemodialysis, intravenous immunoglobulin (IVIG) and noninvasive hemodynamic monitoring.


CONCLUSIONS
Pulmonary edema is easily managed by early hemodialysis. IVIG may be a viable treatment for thrombocytopenia and hemolysis but can induce reversible interstitial nephritis and membranous glomerulonephritis.
Cho
Fu-Nan
FN
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. fncho@isca.vghks.gov.tw
Chen
San-Nung
SN
Kan
Yuen-Yee
YY
Lee
Te-Ching
TC
Wang
Jyh-Seng
JS
D058186:Acute Kidney Injury / Q000150:complications / Q000209:etiology / Q000628:therapy*; D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008991:Monitoring, Physiologic / Q000379:methods; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011654:Pulmonary Edema / Q000150:complications / Q000209:etiology / Q000628:therapy*; D006435:Renal Dialysis
D016756:Immunoglobulins, Intravenous