Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- náuseas y vómitos
- hipertensión
- reflejos osteotendinosos aumentados
Otros factores de diagnóstico
- dolor epigástrico y sensibilidad en el cuadrante superior derecho (CSD)
- 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
Professor of Obstetrics and Gynecology
Vice Chair for Research and Academic Development
Director of the Divisions of Maternal-Fetal Medicine and Research
University of Mississippi Medical Center
Jackson
MI
Divulgaciones
JNM Jr is a maternal-foetal medicine consultant and obstetrician gynaecologist to Mississippi Blue Cross Blue Shield and the Mississippi Perinatal Quality Collaborative. He is a member of several American Congress of Obstetricians and Gynecologists (ACOG) committees including the Global Operations Advisory Group, Compensation, and the Telehealth WorkGroup, chair of the ACOG 2018 Task Force on Pregnancy and Heart Disease, and a member of the International Federation of Gynecology and Obstetrics (FIGO) Non-communicable Diseases Committee. He is a teacher, lecturer, and speaker about HELLP syndrome for the ACOG, Federación LatinoAmericana de Sociedades de Obstetrícia y Ginecologia (FLASOG) and Mexican Federation of Colleges of Obstetrics and Gynecology (FEMECOG). JNM Jr is also an author of a number of references cited in this topic.
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. MGH declares that she has no competing interests. ACV is an author of a number of references cited in this topic.
Revisores por pares
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.
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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