A Case of Injury Associated HELLP Syndrome in a Native American

HELLP Syndrome is a rare and serious complication of pregnancy. It is named for its characteristic presentation of microangiopathic hemolysis, elevated liver enzymes and low platelet count. Disease symptoms include right upper quadrant pain, epigastric pain, nausea, vomiting, malaise and headache in addition to preeclampsia. HELLP Syndrome is associated with abnormalities in the development of the placental vasculature resulting in poor perfusion. This creates a hypoxic state, resulting in anti-angiogenic proteins being released from the placenta, ultimately hindering proper fetal development. The subsequent placental damage results in maternal endothelial cell dysfunction, leading to platelet activation and fibrin deposition in the liver causing tissue necrosis. If left untreated, HELLP Syndrome can lead to liver failure and death of the mother and fetus. The following case study presents an atypical case of HELLP Syndrome in a Native American female following a fall at 32 weeks of gestation.