Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction

Abstract Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low...

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2014-05, Vol.23 (2), p.189-193
Main Authors: Mills, A.T, Davidson, M.E, Young, P
Format: Article
Language:English
Subjects:
Acetaminophen - poisoning
Adult
Analgesics, Non-Narcotic - poisoning
Anesthesia & Perioperative Care
Cesarean Section
Chemical and Drug Induced Liver Injury - therapy
Diagnosis, Differential
Drug Overdose - diagnosis
Drug Overdose - therapy
Female
HELLP syndrome
HELLP Syndrome - diagnosis
HELLP Syndrome - therapy
Humans
Infant, Newborn
Liver dysfunction
Obstetrics and Gynecology
Paracetamol
Postpartum Period
Pregnancy
Toxicity
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Summary:Abstract Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We report a case that was erroneously managed as HELLP syndrome before a paracetamol overdose was diagnosed. This case highlights current practice in managing paracetamol overdose and focuses on the importance of addressing mental health issues to mitigate the risk of self-harm in pregnancy.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2014.01.006