Surgical prophylaxis of bleeding during an the operative delivery in a patient with HELLP syndrome

HELLP-syndrome is rare, but it causes serious pregnancy complications with significantly increased maternal and perinatal morbidity and mortality. To date there is no agreement on its pathophysiology. The only treatment is an emergent delivery, which in turn increases the number of preterm newborns and does not always improve the patient’s condition in a close-time period with a high-risk of postpartum bleeding. To reduce the risk of uterine bleeding in this group of patients, we proposed to use a preventive application of compression sutures to the uterus during surgical delivery.The management of HELLP syndrome in a pregnant woman with a multiple pregnancy (twins) at 34 weeks’ gestation with a favorable outcome is presented. Compression sutures: the B-Lynch and two circular sutures were applied to the uterus to prevent bleeding.HELLP syndrome is a dangerous, sudden and rapidly progressive complication that threatens the life of the mother and fetus. Appliance of preventive compression sutures could reduce blood loss. However, for a wider use of the method, multicenter clinical trials are needed.