34-week primigravida with blood pressure of 165/95 and headache of two days of evolution. Laboratory tests: hemoglobin 10.5 g/dL, platelets 98,000/mm3, AST 356 IU/L (0-31), ALT 234 IU/L (0-31), LDH 878 IU/L (125-243). The laboratory is called because of the presence of schistocytes in the peripheral blood smear. She received the second dose of corticosteroids for fetal maturation 24 hours ago. On obstetric ultrasound the estimated fetal weight is in the 1st percentile for gestational age and the umbilical artery Doppler shows absence of end-diastolic flow. Which of the following is the most indicated clinical approach?
They are describing HELLP syndrome. With these weeks of gestation and with the fetus recently matured (she has already been given two doses of corticosteroids), the attitude is immediate termination.
Expectant management with antihypertensive drugs and magnesium sulfate until the maternal platelets improve.
Expectant attitude with antihypertensive treatment at home and controls every 48 hours.
Termination of gestation when she completes fetal lung maturation.
Immediate termination of pregnancy.
They are describing HELLP syndrome. With these weeks of gestation and with the fetus recently matured (she has already been given two doses of corticosteroids), the attitude is immediate termination.