HELLP SYNDROME AFTER COVID-19 DIAGNOSIS: CASE REPORT

• DOI: 10.22533/at.ed.1593832309109

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• Abstract:

  Case description: Woman, 32 years old, O+, G2N1C1A0, 1st pregnancy uneventful, 2nd pregnancy was monochorionic univiteline twins followed in the high-risk prenatal service at the Hospital Regional de Ceilândia (HRC). At 36 weeks and 4 days, she attended the HRC with a fever, associated with pain in the lower limbs, headache, burning nose, blood pressure spike and pain in the lower abdomen. She had a positive result for a rapid antigen test for COVID-19, had altered transaminases and thrombocytopenia, a condition compatible with HELLP syndrome. She underwent a cesarean section without complications. After a few hours, the patient developed massive bleeding, tachycardia, hypotension, a large number of clots in the vaginal fundus, and intense abdominal pain. A transfusion of two packed red blood cells was prescribed, abdominal computed tomography (CT) was requested and admission to the Intensive Care Unit was indicated. The CT report showed free fluid in the abdomen in moderate quantities. Exploratory laparotomy was performed with total hysterectomy with right salpingectomy, with three more packed red blood cells being transfused. The patient progressed satisfactorily and, the following day, returned to the HRC ward, with no evidence of abdominal bleeding by point-of-care ultrasound.