HELLP syndrome: undiagnosed in a case of impending rupture of uterus. A case report.

A 31-year-old women, 34 weeks gestation with intrauterine fetal death, and transverse lie with impending rupture of the uterus due to obstructed labor, was scheduled for urgent cesarean section. On preoperative anesthetic assessment, she was diagnosed to have HELLP syndrome based on clinical findings (subsequently confirmed by laboratory results). She was anesthetized taking the necessary precautions. Her intra and postoperative course is described. The case demonstrates how the anesthetist is often confronted by undiagnosed HELLP syndrome for urgent cesarean section and has limited time for investigations. He should depend on his clinical acumen to diagnose and treat appropriately for a favorable maternal outcome.