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[HELLP syndrome in triplet pregnancy complicated by DIC and transient diabetes insipidus].
Masui. 1998 Feb; 47(2):195-9.M

Abstract

A 29-year-old woman with a triplet pregnancy received emergency caesarean section in the 33rd week of pregnancy. She lost 2 babies, one of whom was a fetal death and the other a neonatal death. Three weeks before delivery, she was admitted to hospital suffering from vomiting, diarrhea and polyuria. There were no laboratory abnormalities such as a slightly elevated levels of liver enzymes, nor any clinical symptoms of preeclampsia. At the end of the operation, disseminated intravascular coagulation (DIC) occurred and HELLP syndrome was diagnosed. However, the hemoglobin level was in the normal range at this point. On the 2nd postoperative day, hemolytic anemia developed in spite of the resolution of other problems. We suggested that the hemolysis, which may have been caused by a latent hemoconcentration and a membrane disorder of the red cells, was an osmotic hemolysis. This case was unique for the following reasons; 1) a lack of symptoms of hypertension, proteinuria and edema, 2) complications due to diabetes insipidus, 3) postpartum severe hemolysis following latent hemoconcentration, and 4) slow progress of the condition after onset. Early detection of HELLP syndrome is difficult. It should be considered in the management of patients with unrecognizable hemoconcentration and nonspecific complications.

Authors+Show Affiliations

Okada S
Department of Anesthesia, Center for Adult Disease, Kurashiki.
Okada K
No affiliation info available
Nishitani K
No affiliation info available

MeSH

AdultAnemia, HemolyticAnesthesia, GeneralAnesthesia, ObstetricalCesarean SectionDiabetes InsipidusDisseminated Intravascular CoagulationEmergenciesFemaleHELLP SyndromeHumansPerioperative CarePregnancyPregnancy ComplicationsTriplets

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

9513334

Citation

Okada, S, et al. "[HELLP Syndrome in Triplet Pregnancy Complicated By DIC and Transient Diabetes Insipidus]." Masui. the Japanese Journal of Anesthesiology, vol. 47, no. 2, 1998, pp. 195-9.
Okada S, Okada K, Nishitani K. [HELLP syndrome in triplet pregnancy complicated by DIC and transient diabetes insipidus]. Masui. 1998;47(2):195-9.
Okada, S., Okada, K., & Nishitani, K. (1998). [HELLP syndrome in triplet pregnancy complicated by DIC and transient diabetes insipidus]. Masui. the Japanese Journal of Anesthesiology, 47(2), 195-9.
Okada S, Okada K, Nishitani K. [HELLP Syndrome in Triplet Pregnancy Complicated By DIC and Transient Diabetes Insipidus]. Masui. 1998;47(2):195-9. PubMed PMID: 9513334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [HELLP syndrome in triplet pregnancy complicated by DIC and transient diabetes insipidus]. AU - Okada,S, AU - Okada,K, AU - Nishitani,K, PY - 1998/3/26/pubmed PY - 1998/3/26/medline PY - 1998/3/26/entrez SP - 195 EP - 9 JF - Masui. The Japanese journal of anesthesiology JO - Masui VL - 47 IS - 2 N2 - A 29-year-old woman with a triplet pregnancy received emergency caesarean section in the 33rd week of pregnancy. She lost 2 babies, one of whom was a fetal death and the other a neonatal death. Three weeks before delivery, she was admitted to hospital suffering from vomiting, diarrhea and polyuria. There were no laboratory abnormalities such as a slightly elevated levels of liver enzymes, nor any clinical symptoms of preeclampsia. At the end of the operation, disseminated intravascular coagulation (DIC) occurred and HELLP syndrome was diagnosed. However, the hemoglobin level was in the normal range at this point. On the 2nd postoperative day, hemolytic anemia developed in spite of the resolution of other problems. We suggested that the hemolysis, which may have been caused by a latent hemoconcentration and a membrane disorder of the red cells, was an osmotic hemolysis. This case was unique for the following reasons; 1) a lack of symptoms of hypertension, proteinuria and edema, 2) complications due to diabetes insipidus, 3) postpartum severe hemolysis following latent hemoconcentration, and 4) slow progress of the condition after onset. Early detection of HELLP syndrome is difficult. It should be considered in the management of patients with unrecognizable hemoconcentration and nonspecific complications. SN - 0021-4892 UR - https://www.unboundmedicine.com/medline/citation/9513334/[HELLP_syndrome_in_triplet_pregnancy_complicated_by_DIC_and_transient_diabetes_insipidus]_ L2 - http://www.diseaseinfosearch.org/result/3266 DB - PRIME DP - Unbound Medicine ER -