[Anesthesia for a patient with HELLP syndrome].Masui. 1989 Dec; 38(12):1633-7.M
A case of 30 year-old female with HELLP syndrome, who had undergone emergency caesarean section under general anesthesia, was reported. HELLP syndrome is characterized by hemolysis, liver dysfunction and thrombocytopenia, besides symptoms of severe toxemia of pregnancy. After an awake orotracheal intubation, anesthesia was maintained with nitrous oxide, oxygen and muscle relaxant. Blood pressure was controlled with intravenous administration of nitroglycerin. Though the eclampsia was recognized several times during and after the operation, the patient and her baby had no complication nor sequela on their discharge. The key in the anesthetic management of caesarean section in a patient with HELLP syndrome is to control hypertension and eclampsia, to consider the presence of liver and kidney dysfunctions, and to improve anemia and bleeding tendency.