Obstetrical anesthesia for parturient patients with HELLP syndrome

: In the period from April 1995 to March 2000, 11 parturient patients were diagnosed as having HELLP syndrome and underwent Caesarian section at our institution. All of the patients also had eclampsia or preeclampsia. Six of the operations were performed under general anesthesia and 5 were performed under regional anesthesia (one epidural and 4 spinal blocks). Subarachnoid anesthesia was well tolerated and clinically serious decreases in blood pressure with onset of block were not common. In the cases in which general anesthesia was used, control of blood pressure was difficult and the Apgar scores of the babies were low. No major complications occurred during the postoperative periods. Anesthetic management of a parturient patient with HELLP syndrome is modeled on the underlying preeclamptic condition. Determination of the appropriate anesthetic should be based on the patient's condition, condition of the fetus, and the urgency of the situation.