HELLP syndrome associated with severe malaria. A report of three cases

The authors report three cases of pregnancy complicated by HELLP syndrome and severe malaria in three African women (19, 28 and 30 year-old respectively). Clinical and biological signs were those, often similar, of both HELLP syndrome and severe malaria, with predominantly gastroenterological, cardiocirculatory, renal and hepatic disorders. Thrombocytopenia was marked. Diagnosis of paludism was assessed by thick smears and parasitaemia tests. Symptomatic medical treatment was associated with intravenous quinine. Association of HELLP syndrome and severe malaria is extremely severe: of these three cases two parturients deceased rapidly and two fetuses were dead in utero: a healthy neonate was extracted by caesarean section and a patient (not his mother) had a good outcome. Prevention and obstetrical management of this often fatal association are evoked.