Última revisión: 26 Ago 2021
Última actualización: 10 Mar 2021

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • náuseas y vómitos
  • hipertensión
  • reflejos osteotendinosos aumentados

Otros factores de diagnóstico

  • dolor y sensibilidad en el cuadrante superior derecho/epigástrico
  • malestar general
  • cefalea
  • edema
  • alteraciones visuales
  • ictericia
  • sangrado

Factores de riesgo

  • raza blanca
  • edad materna >35 años
  • obesidad
  • hipertensión crónica
  • diabetes mellitus
  • trastornos autoinmunitarios
  • gestación múltiple
  • placentación anormal (p. ej., embarazo molar)
  • embarazo previo con preeclampsia con o sin síndrome HELLP

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • hemograma completo (HC) con diferencial, incluidas plaquetas
  • frotis de sangre periférica
  • transaminasas hepáticas
  • nivel de bilirrubina
  • nivel total de lactato deshidrogenasa (LDH) sérica
  • aumento del nivel de ácido úrico
  • análisis de orina y cociente proteína/creatinina
  • tiempo de protrombina (TP)/tiempo de tromboplastina parcial (TTP)
  • nivel de fibrinógeno
  • ultrasonido fetal

Pruebas diagnósticas que deben considerarse

  • nivel de glucosa sérica
  • niveles de creatinina sérica y electrolitos
  • nivel de antitrombina
  • nivel de haptoglobina
  • ultrasonido, tomografía computarizada (TC) o imagen por resonancia magnética (IRM) de la parte superior del abdomen materno
  • relación entre la lactato deshidrogenasa (LDH) y la aspartato aminotransferasa (AST)

Algoritmo de tratamiento

Colaboradores

Autores

James N. Martin, Jr, MD, FACOG, FAGOS, FAHA, F(H)RCOG

Professor Emeritus of Obstetrics, Gynecology, and Maternal-Fetal Medicine

University of Mississippi Medical Center

Jackson

MI

Divulgaciones

JNM Jr is an obstetrician-gynaecologist and maternal-fetal medicine consultant to BlueCross & BlueShield of Mississippi and the Mississippi Perinatal Quality Collaborative. He is co-director of the Mississippi Maternal Mortality Review Committee. He serves on the Global Operations Advisory Group of the American College of Obstetricians and Gynecologists (ACOG), and in 2018-9 he chaired the ACOG Presidential Task Force on Pregnancy and Heart Disease. JNM Jr lectures, teaches, researches, and speaks nationally and internationally on the subjects of hypertensive complications of pregnancy, including HELLP syndrome. He is also the lead author and editor of 'The 2015 compendium for HELLP syndrome: from bench to bedside' (Nova Biomedical Publishers). JNM Jr is an author of several references cited in this topic. He has cited his own papers in this topic.

Agradecimientos

Dr James N. Martin Jr would like to gratefully acknowledge Dr Marium G. Holland and Dr Alex C. Vidaeff, the previous contributors to this topic.

Divulgaciones

MGH declares that she has no competing interests. ACV is an author of a number of references cited in this topic.

Revisores por pares

Jerome Yankowitz, MD

Professor and Director

Division of Maternal-Fetal Medicine

Department of Obstetrics and Gynecology

University of Iowa Hospitals and Clinics

Iowa City

IA

Divulgaciones

JY declares that he has no competing interests.

Deirdre Murphy, MD, MRCOG

Professor of Obstetrics

Trinity College

University of Dublin

Consultant Obstetrician

Coombe Women and Infants University Hospital

Dublin

Ireland

Divulgaciones

DM declares that she has no competing interests.

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