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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.

Pravastatin for prevention of HELLP syndrome