ABSTRACT
Along with haemorrhage, pre-eclampsia (PET) and associated conditions are likely to be the conditions midwives will most commonly care for in a critical care situation. Predisposing it is acknowledged that PET is a very unpredictable disease and may occur in those with no predisposing factors, it can be useful to identify those at increased risk of developing this condition. Haemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome is a serious complication usually associated with PET but in which many women do not develop significant hypertension or proteinuria. The most common presenting signs for those women with HELLP include epigastric or abdominal pain, nausea or vomiting, headache, visual changes, new-onset hyper-tension and/or new-onset proteinuria. The physiology of acute fatty liver of pregnancy (AFLP) is not yet clearly identified, but it is thought that AFLP may be a variant of PET. It is characterised by hepatic microvesicular steatosis associated with mitochondrial dysfunction.
