Although Hellp syndrome is defined as a variant of preeclampsia, hypertension and proteinuria, which are the diagnostic features of preclampsia, can occur in the late stages of hellp syndrome. In some cases, proteinuria and hypertension may not develop at all in hellp syndrome. Also, in one third of cases, hellp syndrome may occur in the postpartum period [186]. The diagnosis of hellp syndrome can be made late when it appears with vague findings such as abdominal pain, nausea and vomiting. Realization of delivery on time is the main purpose of hellp syndrome management. In patients with hellp syndrome without a term pregnancy, delivery may be delayed for a certain period of time to apply the steroid for providing fetal lung maturation [180]. Also, in some cases where the gestational week is small and the mother is stable, maintaince treatment can be applied. This maintaince treatment is mostly performed in the tertiary centers where all conditions are met for high-risk pregnancy and where the perinatalog is located.
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