Sibel TAMER, Tahir Kurtuluş YOLDAŞ, Ufuk ŞENER, Hafize Nalan GÜNEŞ

Hellp Sendromlu Hastada Gelişen İntrakranial Hemoraji

HELLP sendromu H=Hemoliz, EL=Karaciğer enzimlerinde yükselme, LP=Platelletlerde azalma yaygın mikroanjiopatilere bağlı olarak genellikle multipar bayanların üçüncü trimestirinde ortaya cıkan kötü prognozlu multisistemik bir hastalıktır. İntraserebral komplikasyonlar sık olmamakla birlikte HELLP sendromunda en sık ölüm nedenidir. HELLP sendromunun erken tanınması ve tedavinin hızlı başlanması, anne –bebek prognozunun düzeltilmesi için gereklidir. Bu yazıda, HELLP sendromunda gelişen ve başarıyla tedavi edilen intraserebral hemoraji olgusu sunulmuştur

Anahtar Kelimeler:

HELLP sendromu, intraserebral kanama, tedavi

Intracranial Haemorrhage in a Patient With Hellp Syndrome

HELLP syndrome H=Haemolysis, EL=Elavated Liver Enzymes, LP=Low Platelets is a multisystemic disorder that has a poor prognosis and occurring usually in older multiparous women in the third trimester of pregnancy due to a generalized microangiopathy. Intracerebral complications including hemorrhage and infarct are rare but one of the most common causes of death in patients with HELLP syndrome. The early recognition of HELLP syndrome and the rapid initiation of therapy are required for the improvement of materno-fetal prognosis. The present report describes a case of intracerebral hemorrhage, developed in HELLP syndrome and had been successfully treated

Keywords:

HELLP syndrome, ıntracerebral haemorrhage, therapy,

___

Weinstein L. Preeclampsia/eclampsia with hemolysis, elevated liver enzymes and thrombocyyopenia. Obstet Gynecol 1985;66:657-60
Sezik M, Özkaya MO, Sezik HT, Yapar E, Kaya H. HELLP send- romlu hastalarda umblikal arter doppler incelemesinin perinatal sonuçlarla ilişkisi. Perinatoloji Dergisi 2005;13: 198-202.
Keleş GT, Topçu İ, Kefi A, Ekinci Z, Sakarya M. Yoğun bakım ünitesinde obstetrik olgular. Fırat Tıp Dergisi 2006;11: 62-5.
Nakayama D, Isimaru T, A case of postpartum cerebellar infarcti- on with hemolysis, elevated liver enzymesi, low platelets HELLP syndrome. Gynecol Obstet Invest 2002; 53:240-2
Knopp U, Kehler U, Riskmann H, Amold H, Gliemroth J. Cereb- ral haemodynamic pathologies in HELLP syndrome. Clin Neurol Neurosurg 2003; 105:256-61
Klatsky AL, Friedman GD, Sidney S, Kipp H, Kubo A, Armstrong MA. Risk of hemorrhagic stroke in Asian-American ethnic groups. Neuroepidemiology 2005;25:26–31
Zeidman LA, Videnovic A, Berstein LP, Pellar CA Lethal ponti- ne hemorrhage in postpartum syndrome of hemolysis, elevated liver enzyme levels, and low platelet count. Arch Neurol 2005; 62:1150-1153.
Hashiguchi K, Inamura T, Irita K, Abe M, Noda E, Yanai S, Ta- kahashi S, Fukui M. Late occurrence of diffuse cerebral swel- ling after intracerebral hemorrhage in a patient with the HELLP syndrome . Neurol Med Chir 2001;41:144-148.
Sibai BM. Treatment of hypertension in pregnant women. N Eng J Med 1996;335: 257-65
Martin JN Jr, Perry KG Jr, Blake PG, May WA, Moore A, Ro- binette L. Beter maternal outcomes are achieved with dexamet- hasone therapy for postpartum HELLP (hemolysis, elevated liver enzymes and trombocytopenia) syndrome. Am J Obstet Gynecol 1997;177: 1011-7
Isler CM, Magann EF, Rinehart BK, Terane DA, Bass JD, Martin JN Jr. Dexamethasone compared with betamethasone for gluco- corticoid treatment of postpartum HELLP syndrome. Int J Gynae- col Obstet 2003;80: 291-7