Delayed Postpartum Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome Successfully Treated with Dexamethasone

Abstract

The treatment of choice for preeclampsia is delivery. However, delivery is not always the end of preeclampsia. We present a case of preeclampsia complicated by postpartum hemolysis, elevated liver enzymes, and low platelets syndrome 30 hours after delivery and treated by high dose steroid. A 34-year-old pregnant woman with severe preeclampsia at 35 weeks of gestation was admitted for close observation. All antenatal laboratory studies performed showed no abnormality. Due to uncontrolled blood pressure and severe headache, induction of labor was decided and successful vaginal delivery was accomplished. On the second day of postpartum period, upper abdominal pain developed and laboratory studies including liver enzymes and platelets suddenly became abnormal. On the next day, liver enzymes and platelet count were far more aggravated. To stop progression, intravenous dexamethasone (10 mg) was administered at 46 hours postpartum. Liver enzymes and platelet counts recovered immediately after administration of steroid.