title: [HELLP syndrome with severe liver dysfunction: a presentation of three cases].
abstract: HELLP syndrome (HS) occurs in 0.5-0.9% of pregnant women. According to the Tennessee criteria, it is characterised by haemolytic anaemia, thrombopenia and multi-organ dysfunction. The purpose of this article is to present the cases of four pregnant women diagnosed with HS with severe liver involvement.
  
  
  METHODS
  We present the cases of 4 pregnant women of 24, 27, 28 and 36 weeks gestation, respectively. Pregnancy was terminated by urgent Caesarean section in all 4 cases. The first case required a right hepatectomy, with a good post-operative outcome; the second patient developed fulminant liver failure, dying due to multi-organ failure while waiting for a liver transplant. The third patient progressed satisfactorily with conservative medical treatment. The fourth patient required two livers transplants, being discharged from hospital three months later.
  
  
  CONCLUSIONS
  When faced with the clinical suspicion of a HS it is essential to rule out a liver haematoma, since the treatment of choice depends on its clinical-radiological severity. If there is a rupture of the haematoma, urgent surgery is essential and, in the case of severe liver failure, a liver transplant is indicated.
authors: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen Arrixaca, Murcia, España. sbuenof@um.es
authors: Francisco
authors: F
authors: Sánchez-Bueno
authors: Rocío
authors: R
authors: García Pérez
authors: Gloria
authors: G
authors: Torres Salmerón
authors: Jezabel
authors: J
authors: Fernández-Carrión
authors: Pablo
authors: P
authors: Ramírez Romero
authors: Pascual
authors: P
authors: Parrilla Paricio
mesh_terms: D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D012720:Severity of Illness Index