[Severe EPH gestoses and pre-eclampsia in relation to hemolysis, increased liver enzymes and decreased thrombocytes--a report of experiences in emergency obstetric situations].

An increasing number of patients with hemolysis, elevated liver enzymes, and low platelet count (HELLP) have been noted in recent years. We report 11 patients at the Department of Obstetrics (University of Bonn), who were admitted during the past 3 years at between the 24th and 37th week of gestation, showing the typical symptoms of the HELLP syndrome with epigastrical pain and characteristic changes in the blood serum, partly associated with severe EPH gestosis or preeclampsia. No predisposition was found in the medical or pregnancy history. The aggravation of symptoms in combination with insufficient progress of delivery made cesaerian section necessary. In spite of intensive-care measures, two mothers and three newborns died. We present a proposal for obstetrical diagnosis and management.