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This case report is about a 25-year-old patient with microangiopathic in toxemic pregnancy. Clinical manifestations are such as hemorrhage in digestive system and urinary tract accompanied with anemia thrombocytopenia, liver, and kidney, disorder. The clinical diagnosis for this patient was HELLP syndrome, with all of the clinical manifestations of this syndrome the patient was admitted to the 5th Azar Hospital in Gorgan. All of the clinical manifestations and paraclinical observation returned to normal during one and three weeks respectively. The prevalency of this syndrome among the total pregnancies is about 0.2%-0.8% and the risk of recurrence of this disorder is about 3-25%.

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Background and Objective: Liver enzyme tests are usually normal or slightly increased during pregnancy. Abnormal liver enzyme tests are seen in 3% of pregnancies and should be evaluated immediately. Early detection and timely treatment is the key to successful treatment. This study was carried out to determine the prevalence of abnormal liver enzymes and pregnancy outcome in women admitted to Sayyad-e-Shirazi hospital in Gorgan-north of Iran.
Methods: This descriptive, cross-sectional study was carried out on 73 hospitalized pregnant women out of 6680 pregnant women in the Sayyad Shirazi hospital, in north of Iran during April to September 2015. Clinical information was including laboratory tests, final diagnosis and complications postpartum of 73 women with impaired liver enzymes.
Results: The most common cause of abnormal liver enzymes were pre-eclampsia in pregnant women (16 patients 21.9%) which occured in the third trimester. HELLP syndrome was observed in 9 (12.3%) of patients which occurred in the third trimester. Also in 3 cases (4.1%) eclampsia was reported in the third trimester.
Conclusion: Due to the high incidence of pre-eclampsia and HELLP syndrome in women with impaired liver enzymes, careful examination of patients, especially in the third trimester of pregnancy is essential.