A 32yo woman of 39wks gestation attends the antenatal day unit feeling very unwell with
sudden onset of epigastric pain a/w nausea and vomiting. Temp 36.7C. Exam: RUQ tenderness.
Bloods: mild anemia, low plts, elevated LFT and hemolysis. What is the most likely dx?
a. Acute fatty liver of pregnancy
b. Acute pyelonephritis
d. HELLP syndrome
e. Acute hepatitis
Ans. The key is D. HELLP syndrome. [H=hemolysis, EL=elevated liver enzyme, LP=low platelet count].