Abstract:
HELLP (haemolysis, elevated liver enzymes and low platelet count) syndrome has been recognised as
a life threatening complication of pregnant women for many years. The majority of women with HELLP
syndrome have hypertension and proteinuria which may be absent in 10e20% of casesereferred to as
atypical HELLP. A primigravida received epidural labour analgesia and she continued to bleed from the
skin puncture site. Evaluation for the cause of bleed established the diagnosis of atypical HELLP
syndrome. Although rarely encountered, an atypical HELLP may have dangerous anaesthetic conse-
quences when clinicians are caught unawares. We report one such case with atypical presentation.
