Eclampsia and HELLP syndrome

Four minutes, in order. The midwife calls you to a bed at 32 weeks. The woman is rigid, then jerking, and the bed rail is banging. Her partner is shouting. There is a cardiotocograph running and it has gone flat. The order below: left lateral, oxygen, magnesium, pressure, labs, fetal assessment, birth planning.[3][9]

Overview and definition

Eclampsia is a generalised tonic-clonic seizure in a woman with preeclampsia, with no other cause found. It sits inside the ISSHP 2021 neurological criterion, and it is a manifestation of the disease rather than a separate condition.[1][3]

HELLP syndrome is haemolysis, elevated liver enzymes and a low platelet count — a severe end of the preeclampsia spectrum that can arrive without much hypertension and without any proteinuria.[10][3]

• Timing of eclampsia: antepartum, intrapartum, postpartum, and late postpartum (more than 48 hours after birth). Postpartum seizures are a substantial share.[9][19]
• HELLP timing: roughly two-thirds antepartum, one-third postpartum, with the postpartum group typically presenting within 48 hours of birth.[10][3]