LAUSR

Rationale: Pravastatin has emerged for prevention and treatment of preeclampsia; no reports are available on pravastatin and HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome. Patient concerns: The first pregnancy necessitated termination of pregnancy at gestational age (GA) 20+5 for HELLP. Intrauterine fetal death at GA 22+5 occurred in the second pregnancy, whilst on temporizing management of HELLP. Diagnoses: Severe, recurrent early-onset HELLP syndrome. Interventions: In her fourth pregnancy, pravastatin was commenced at GA 13. Outcomes: The course of pregnancy was uncomplicated, and a healthy, appropriate for gestational age fetus was delivered at term. Lessons: Pravastatin may be effective in prevention of HELLP. The hepatic uptake may be of particular advantage.