Preeclampsia complicated by placental abruption, HELLP, coagulopathy and renal failure - further lessons.

We present a case of preeclampsia complicated by HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome and marked coagulopathy. The severity of the coagulopathy and haemolysis made renal failure and pulmonary oedema inevitable. We identified a number of discussion points in this case. These were the delay to appreciate the haemolysis, the severity of the haemolysis and its interaction with the treatment of coagulopathy and the conservative management of pulmonary oedema. At these points there were shortcomings in our management of this complex case that merit further discussion.