Jayawardena L, et al. - In this retrospective analysis, researchers have characterized the natural history of HELLP syndrome by providing contemporary data from the eight-year experience at The Royal Women's Hospital in Melbourne. The study sample consisted of the presentation of clinical and biochemical changes, natural history and outcomes for 43 women whose delivery according to Sibai's criteria was complicated by HELLP syndrome. According to results, two stillbirths and no neonatal or maternal deaths occurred. Most women delivered via caesarean section. Because of vague and variable presentation, misdiagnosis and delayed recognition of HELLP syndrome are common. After delivery, laboratory tests showed improvement, with the platelet count showing the fastest postpartum recovery. For more than a third of patients, hypertension was absent at present. In order to avoid catastrophic maternal and neonatal outcomes, delivery is required when HELLP syndrome is identified. By providing contemporary evidence of the presentation and clinical course of pregnancies complicated by HELLP syndrome, the authors hope to provide guidance to general and obstetric doctors.