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Babesia microti Infection in Pregnancy Mimicking HELLP Syndrome

Tariro Mupombwa, Bethany M. Mulla, James E. Kirby and Barbara M. O’Brien

Babesiosis during pregnancy is an uncommon cause of hemolysis during pregnancy and may have a similar presentation to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. We report a case of a 34- year-old healthy gravida 3 para 1-0-1-1 at 38 weeks of gestation who was transferred to our tertiary care center for induction of labor for suspected HELLP syndrome. Peripheral blood smear from the referring hospital showed intraerythrocytic ring forms consistent with Babesia microti infection. She was treated with clindamycin and quinine and had a vaginal delivery of a healthy infant. This case demonstrates that although uncommon, babesiosis should be on the differential for imitators of HELLP syndrome to optimize treatment and outcomes.