HELLP Syndrome Initial Priority — FRCA Final MCQ

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ModerateObstetric AnaesthesiaHELLP Syndrome Initial PriorityFRCA Final

Primigravida 34 weeks: epigastric pain, platelets 72, ALT 320, schistocytes, BP 162/104. Most important initial management?

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Correct answer: B — IV MgSO4 for seizure prophylaxis and plan delivery

HELLP syndrome: MgSO4 for seizure prophylaxis (prevents eclampsia) + plan delivery (definitive treatment). Loading 4g IV/15 min, maintenance 1g/h. Platelet transfusion only if <50 + bleeding or <75 for regional. Dexamethasone may transiently improve platelets but doesn't alter outcome.

Reference: NICE – 2023 – NG133 Hypertension in pregnancy