The key to your answer would revolve around accurate interpretation of lab results of liver function tests, full blood count with emphasis on the platelet count and the hemoglobin level and also the urea and electrolytes. These would guide on other symptoms associated with HELLP. Correction of abnormalities in these would be most benefitial to management.
For normotensive eclampsia, a good reference is Douglas & Redman's BEST (British Eclampsia Survey Team) publication, and Sibai has described the condition of normotensive HELLP syndrome among other atypical presentations of pre-eclampsia. In our fullPIERS and miniPIERS projects, we did have a number of women who presented with normotensive HELLP syndrome. Steegers et al (Lancet 2010) has a table describing HELLP mimickers.
Martin et al (1999) describes 777 patients with HELLP syndrome; 30% of women with Class I HELLP had been normotensive on admission. They consider the value of symptoms and lab tests to predict significant maternal morbidity.
Preeclampsia is defined as the presence of hypertension (BP ≥140/90 mm Hg) on 2 occasions, at least 6 hours apart, but without evidence of end-organ damage, in a woman who was normotensive before 20 weeks' gestation or if SBP has increased by 30 mm Hg or if DBP has increased by 15 mm Hg.
So, first question is: how much was the blood pressure at the beginning of the pregnancy?
If at the start of pregnancy, the pregnant had a blood pressure of 90/60, when the pressure of this pregnant will have values of 120/80 is already hypertension.
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