Grey’s Anatomy Illuminates the Tragedy of Preeclampsia Misdiagnosis

It is said that art imitates life and the episode “Personal Jesus” in Season 14 of Grey’s Anatomy revealed some hard-core facts: patients die unnecessarily because of missed diagnosis.

Three patients entered the fictitious Seattle Grace Mercy West Hospital and none of them left alive, including a woman who had just given birth to a healthy baby at 37 weeks. She was in labor at 37 weeks with a “normal” blood pressure but died of something called the “HELLP” Syndrome that is associated with pre-eclampsia.

 

“HELLP” is an acronym for hemolysis (breakdown of red blood cells), elevated liver enzymes and low platelets which help the blood clot thereby avoiding hemorrhage.

Regretfully, the HELLP syndrome begins rapidly either before or shortly after a delivery, is aggressive and is one of the leading causes of maternal death. The admitting physician (Dr. April Kepner) was distraught because she obviously missed the diagnosis. She later learned that the deceased patient’s blood pressure had been “low” during her pregnancy so when it was “normal” on hospital admission, it was really elevated and thus began the journey of a medical misdiagnosis.

Could the tragedy of the fictionalized patient in Grey’s Anatomy been avoided? Perhaps, if the physicians had a heightened level of suspicion based on her risk factor of first pregnancy. First-time pregnant moms are at a greater risk of developing preelampsia so a brief discussion should have been made in the medical records along with the “low blood pressure.”

Tragically, the Center for Disease Control (CDC) reported over 5,000 maternal deaths of women who delivered within a year of giving birth from 2011 to 2013.  This represent an increase in maternal mortality from 7 percent to 15 percent. Despite these dismal statistics, there are things that clinicians can do to fight this battle which include being more proactive by looking for this disease even before a patient is in a state of crisis.  We, as clinicians can do better and we MUST do better. Too many women are dying.

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