Los trastornos hipertensivos en el embarazo siguen constituyendo una importante causa de morbimortalidad materna principalmente secundaria a hemorragias cerebrales y mortalidad perinatal, debido a la prematuridad, restricción del crecimiento intrauterino (RCIU), y abruptio de placenta. El síndrome de HELLP, por sus siglas en ingles H: haemolysis, EL: elevated liver enzymes and LP: low platelets, las cuales surgieron como propuesta de Weinstein posterior a un estudio realizado con gestantes en las cuales encontró similitud de sus síntomas, es considerado como una de las complicaciones más severas de la preeclampsia; que involucra en su diagnóstico la triada de hemólisis, enzimas hepáticas elevadas y trombocitopenia. Se caracteriza por ser una patología multisistémica que afecta entre el 0,5 al 0,9% de todos los embarazos, donde aproximadamente el 70 % aparece entre las 27-37 semanas, el 20 % posterior a las 37 semanas y el 10 % restante previo a las 27 semanas. Su fisiopatología está relacionada con problemas de placentación y el manejo se basa en la finalización del embarazo independientemente de la edad gestacional, con el apoyo en unidades con disponibilidad de cuidados intensivos neonatales y obstétricos. La etiología no está definida, sin embargo, los factores de riesgo son comunes a los de la preeclampsia y el tratamiento principal es la terminación del embarazo. Se expone un caso de gestante con síndrome de HELLP, en el hospital Teófilo Dávila de la ciudad de Machala, la cual cursó con alteraciones clásicas en los exámenes de laboratorio, cifras de tensión arterial elevadas de difícil control, tratada de manera exitosa en la referida casa de salud. Palabras clave: HELLP, trombocitopenia, preclampsia, hemolisis, hipertensión. ABSTRACT Hypertensive disorders in pregnancy continue to be an important cause of maternal morbidity and mortality, mainly secondary to cerebral hemorrhages and perinatal mortality, due to prematurity, intrauterine growth restriction (IUGR), and placental abruption. HELLP syndrome, for its acronym in English H: haemolysis, EL: elevated liver enzymes and LP: low platelets, which emerged as Weinstein's proposal after a study carried out with pregnant women in whom he found similarity of their symptoms, is considered as one of the most severe complications of preeclampsia; that involves in its diagnosis the triad of hemolysis, elevated liver enzymes and thrombocytopenia. It is characterized by being a multisystem pathology that affects between 0.5 and 0.9% of all pregnancies, where approximately 70% appear between 27-37 weeks, 20% after 37 weeks and the remaining 10% prior to 27 weeks. Its pathophysiology is related to placentation problems and management is based on the termination of pregnancy regardless of gestational age, with support in units with availability of obstetric and neonatal intensive care. The etiology is not defined; however, the risk factors are common to those of preeclampsia and the main treatment is termination of pregnancy. The case of a pregnant woman with HELLP syndrome is presented, in the Teófilo Dávila hospital in the city of Machala, who presented with classic alterations in laboratory tests, high blood pressure figures that are difficult to control, successfully treated in the aforementioned health house. Keywords: HELLP, thrombocytopenia, preeclampsia, hemolysis, hypertension.
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