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EDITORIAL COMMENT: We accepted this paper for publication to remind readers that microangiopathic haemolysis or the HELLP syndrome can present postpartum in women with preeclampsia especially if the condition has been treated conservatively which is usually done in an attempt to gain fetal maturity. It seems to the editorial staff that the take-away message of this paper is that liver and renal function tests and coagulation studies are necessary in all patients with preeclampsia especially if delivery is to be deferred. Also when microangiopathic haemolysis occurs postpartum it is probably a manifestation of further deterioration of the severe preeclampsia and not due to haemolytic uraemic syndrome or thrombotic thrombocytopenia purpura. The differentiation of these disorders is detailed in the Discussion section of this paper.

The Editor asked the authors to perform an audit of all cases of preeclampsia seen in their institution in a 12-month interval to provide readers with insight concerning the frequency of severe preeclampsia with or without microangiopathic haemolysis.

Authors'reply: A 12-month audit of the cases of preeclampsia within our hospital for the year 1995 revealed 128 cases of mild preeclampsia and 130 of severe preeclampsia. In 1995 there were 5,119 deliveries including all booked and nonbooked patients. Of those with severe preeclampsia there were 8 cases of HELLP syndrome, of which 4 occurred postpartum and 3 are presented in this paper. Thrombocytopenia with a platelet count of less than 150,000/L was found in 26 patients. Clearly microangiopathic haemolysis is an uncommon occurrence particularly when it is seen for the first time postpartum.