A 34-week pregnant woman presents with a sudden drop in platelets from 200,000 to 90,000 per microliter and a drop in hematocrit from 37% to 29% within one week. Which of the following laboratory findings is most likely to also be present in this patient?

1. A

   Increased red blood cells

2. B

   Decreased AST

3. C

   Increased AST

4. D

   Increased hemoglobin

Appeared in: NORCET-11 Prelims

Explanation

• HELLP syndrome is defined by Hemolysis, Elevated Liver enzymes, and Low Platelets.
• Elevated AST is a key laboratory marker of liver injury in HELLP.
• The combination of thrombocytopenia, anemia, and increased AST is diagnostic.

Why Other Options Were Wrong

• Option A: Increased red blood cells are not seen in HELLP syndrome. Hemolysis leads to anemia, not polycythemia.
• Option B: Decreased AST is not a feature of HELLP syndrome. Instead, AST is elevated due to liver cell injury.
• Option D: Increased hemoglobin is not expected in HELLP syndrome. Hemolysis and blood loss cause a drop in hemoglobin and hematocrit.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Recognition of laboratory findings in HELLP syndrome during pregnancy to guide bedside assessment, documentation, and the next nursing action.
• Early recognition of HELLP syndrome is critical for maternal and fetal safety.
• Nurses should monitor for signs of hemolysis, elevated liver enzymes, and low platelets in hypertensive pregnant patients.
• What if? If AST was normal but platelets were low, consider other causes like gestational thrombocytopenia or ITP, not HELLP.

How to Approach the Question

• Identify the clinical syndrome from the pattern of lab changes (platelets, hematocrit, pregnancy timeline).
• Recall the meaning of the HELLP acronym and its diagnostic criteria.
• Eliminate options that do not fit the pathophysiology of hemolysis and liver injury.
• Choose the laboratory finding that is a direct result of liver cell damage (increased AST).
• For similar questions, always match the clinical scenario to the classic triad of HELLP.

Concept Tested & Keywords

• Concept Tested: Recognition of laboratory findings in HELLP syndrome during pregnancy
• Stem keywords: 34-week pregnant woman, drop in platelets, drop in hematocrit, laboratory findings
• Lead-in keywords: most likely to also be present
• Clinical cues: Sudden drop in platelets and hematocrit in late pregnancy
• Clinical cues: Suggests HELLP syndrome

Question ID

Qsnk15qnWd9qHk1y3pkS52

Copy ID

Reference Book

E6 Obstetrics Williams p. 6-17