Abstract
HELLP syndrome, defined by hemolysis, elevated liver enzymes, and low platelets, is a life-threatening complication of preeclampsia that rarely coincides with acute pancreatitis during pregnancy. This combination poses profound risks for both mother and fetus. We describe a 29-year-old woman at 27 weeks of gestation who presented with severe abdominal pain, vomiting, and a history of hypertension. Laboratory evaluation revealed anemia, thrombocytopenia, elevated liver enzymes, renal dysfunction, and high amylase and lipase, confirming the diagnosis of HELLP syndrome associated with acute pancreatitis. Intensive care management included hemodynamic support, electrolyte correction, blood product transfusion, antihypertensive therapy, and an emergency cesarean section. Both maternal and neonatal outcomes were favorable. This case underscores the importance of early multidisciplinary intervention and comprehensive diagnostic evaluation when HELLP syndrome presents with atypical features such as pancreatitis. Prompt recognition and coordinated management are crucial to optimizing maternal and fetal outcomes in these rare and serious presentations.