“Síndrome de hellp como complicación de preeclampsia”

Abstract

Our current case is about a 21-year-old patient with no significant personal history, taking her first pregnancy with 37 weeks of gestation on admission and verbally referring at least 6 prenatal controls not confirmed due to loss of prenatal care card, the pregnant woman go to your local health house referring to headache and abdominal pain type contraction, place where to take vital signs blood pressure of 160/100 mmhg, and a new shot at 2 hours reporting the same figures, no changes are reported cervical, was diagnosed as a hypertensive disorder of pregnancy type severe preeclampsia with signs of severity more threat of preterm delivery, where they refer was established impregnation with magnesium sulfate with first dose of fetal lung maturation and is referred to health home of greater complexity level. It was evaluated in the emergency service of the General Hospital Latacunga where blood pressure of 125/77 mmHg was found without accompanying symptomatology to the obstetric examination was detected unique cephalic alive product with present movements with fetal heart rate of 140 bpm and uterine activity of 1/10 / 20 ", to the genital touch: posterior cervix with 1cm dilatation and 10% effacement. It was decided to enter the Gynecology and Obstetrics service with pregnancy diagnoses of 37 weeks for FUM + preeclampsia without signs of severity + early labor with a spontaneous evolution plan.

At 48 hours after admission, he presented with severe headache, which was associated with pain in the epigastrium, presenting high arterial tension (155/98 mmHg) with regular uterine activity and pelvis not suitable for touch, in addition to laboratory tests that report, PLATELETS: 97 10 ^ 3 / Ul, TGO: 157.20 U / L, TGP: 97.00 U / L, LDH: 865 U / L;

with which are added the diagnoses of: cephalopelvic disproportion maternal factor and Hellp syndrome type II secondary to preeclampsia with signs of severity, reasons why it is decided to terminate the pregnancy by caesarean section, due to risk of compromise of well-being fetal, with posterior fundic placenta with a 4x2 cm pediculated subserous myoma on the anterior uterine surface. After three days, responding favorably and improving the clinical picture, the discharge was decided with a medical appointment scheduling for control and monitoring of the case.