Second and third trimesters :
HELLP Syndrome :
Continued. .
HELLP syndrome - management for cesarean birth:
Use general anesthesia if platelet count is < 75,000 / mm3.
Transfuse 5 to 10 units of platelets before surgery if platelet count is < 50,000 / mm3.
Leave vesico uterine peritoneum open.
Install subfascial drain.
Schedule secondary closure of skin incision or subcutaneous drain.
Administer postoperative transfusions as needed.
Perform intensive monitoring for at least 48 hours postpartum.
Consider dexamethasone (10 mg IV every 12 hours) until postpartum resolution of disease occurs.
HELLP syndrome - management of women with a subcapsular liver hematoma:
General considerations - blood bank aware for potential need of many units of blood.
General or vascular surgeon consultation.
Avoid direct and indirect manipulation of liver.
Closely monitor hemodynamic status.
Management of hematoma depends on whether it is ruptured or not.
HELLP Syndrome :
Continued. .
HELLP syndrome - management for cesarean birth:
Use general anesthesia if platelet count is < 75,000 / mm3.
Transfuse 5 to 10 units of platelets before surgery if platelet count is < 50,000 / mm3.
Leave vesico uterine peritoneum open.
Install subfascial drain.
Schedule secondary closure of skin incision or subcutaneous drain.
Administer postoperative transfusions as needed.
Perform intensive monitoring for at least 48 hours postpartum.
Consider dexamethasone (10 mg IV every 12 hours) until postpartum resolution of disease occurs.
HELLP syndrome - management of women with a subcapsular liver hematoma:
General considerations - blood bank aware for potential need of many units of blood.
General or vascular surgeon consultation.
Avoid direct and indirect manipulation of liver.
Closely monitor hemodynamic status.
Management of hematoma depends on whether it is ruptured or not.
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