🎙️ MSRA Deep Dive: HELLP Syndrome Explained
Welcome to another high-yield episode of the MSRA revision series! Today we unpack HELLP Syndrome, a critical obstetric emergency. This is based on our detailed revision notes to help you master this challenging topic quickly and clearly — perfect for your MSRA prep! 🎯

📌 Definition
HELLP = Haemolysis, Elevated Liver enzymes, Low Platelets
A life-threatening complication of pregnancy, often associated with pre-eclampsia. Usually appears in the 3rd trimester or postpartum.

📌 Causes & Risk Factors
🔹 Placental dysfunction
🔹 Immune/endothelial dysfunction
🔹 Risk ↑ with:
 • Age >35
 • Nulliparity
 • Multiple gestation
 • Previous HELLP
 • APS (Antiphospholipid Syndrome)

📌 Symptoms
😖 RUQ or epigastric pain
🤢 Nausea & vomiting
😵 Headache, malaise
🧑‍⚕️ Hypertension, proteinuria
🩸 Bruising, petechiae (due to thrombocytopenia)

🕑 Remember: 30% occur postpartum (often within 48 hrs)

📌 Investigations
🧪 Bloods:
 • ↑ ALT/AST (>70 IU/L)
 • ↓ Platelets (<100 x 10⁹/L)
 • ↑ LDH (>600 IU/L), bilirubin
 • Blood film: schistocytes

🧪 Others:
 • Urinalysis: proteinuria
 • Imaging: US or CT if liver damage suspected

📌 Management
👩‍⚕️ Stabilise & Deliver
 • Delivery = definitive treatment (usually after 34 weeks)
💉 Magnesium sulfate = for seizure prophylaxis
💊 Antihypertensives: labetalol, nifedipine
💉 Platelet transfusion if <25 x 10⁹/L
🩸 Consider FFP or cryoprecipitate in DIC

📌 Complications
🚨 For Mother:
 • DIC
 • Acute kidney injury
 • Liver rupture
 • Eclampsia
 • Stroke
 • Death (1–25%)

🚼 For Baby:
 • IUGR
 • Preterm delivery
 • Perinatal death (7–34%)

📌 Key Takeaway
HELLP is a haematological and hepatic emergency. Early recognition and prompt delivery are essential to reduce maternal and neonatal morbidity/mortality.

🎓 Useful Revision Resources
📘 Revision Notes → https://www.passthemsra.com/topic/hellp-syndrome-revision-notes/
🃏 Flashcards → https://www.passthemsra.com/topic/hellp-syndrome-flashcards/
📚 Q&A Accordion → https://www.passthemsra.com/topic/hellp-syndrome-accordion-qa-notes/
🧠 Rapid Quiz → https://www.passthemsra.com/topic/hellp-syndrome-rapid-quiz/
🩺 Quiz Platform → https://www.passthemsra.com/quizzes/hellp-syndrome/
🎓 O+G MSRA Course → https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/

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