title: Microcirculation Approach in HELLP Syndrome Complicated by Posterior Reversible Encephalopathy Syndrome and Massive Hepatic Infarction.
abstract: HELLP syndrome is a complication of severe forms of preeclampsia and occurs mainly in the third trimester of pregnancy. In extreme cases, it may evolve unfavorably and substantially increase maternal mortality. We present the case of an 18-year-old pregnant woman who was admitted to our emergency service in her 31st week, presenting with headache, visual disturbances, and epigastralgia, with progression to a severe condition of HELLP syndrome followed by posterior reversible encephalopathy syndrome (PRES) and hepatic infarction. We highlight the approach taken towards this patient and the case management, in which, in addition to the imaging examinations routinely available, we also used the sidestream dark field (SDF) technique to evaluate the systemic microcirculation.
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Stephanno Gomes Pereira
authors.initials: SG
authors.lastname: Sarmento
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Eduardo Feliz Martins
authors.initials: EF
authors.lastname: Santana
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Felipe Favorette
authors.initials: FF
authors.lastname: Campanharo
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Edward
authors.identifier: 0000-0002-6145-2532
authors.initials: E
authors.lastname: Araujo Júnior
authors.affiliation: Department of Medicine, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), 05303-000 São Paulo, SP, Brazil.
authors.forename: Flavia Ribeiro
authors.initials: FR
authors.lastname: Machado
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Nelson
authors.identifier: 0000-0001-7187-1004
authors.initials: N
authors.lastname: Sass
authors.affiliation: Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil.
authors.forename: Antonio Fernandes
authors.initials: AF
authors.lastname: Moron