Primigravida with Intrauterine Fetal Demise (IUD) Complicated by Severe Preeclampsia, HELLP Syndrome, Disseminated Intravascular Coagulation (DIC), Sepsis, and Multi-Organ Dysfunction Syndrome (MODS): A Rare Case Report

Abstract Background: HELLP syndrome is a rare but severe complication of preeclampsia that can rapidly progress to disseminated intravascular coagulation (DIC), sepsis, and multi-organ dysfunction syndrome (MODS), posing significant risk to maternal and fetal survival. Intrauterine fetal demise (IUD) in such cases further complicates clinical outcomes. Case Presentation: We report the case of a 28-year-old primigravida at 27+6 weeks of gestation who presented with abdominal pain, per vaginal bleeding, and reduced fetal movements. Her clinical course was preceded by a febrile illness and respiratory symptoms. Upon evaluation, IUD was confirmed. The patient was diagnosed with severe preeclampsia, HELLP syndrome, DIC, acute kidney injury, and MODS. She underwent induction of labour and delivered a stillborn female foetus. Despite complications including hypotension, coagulopathy, and renal dysfunction, prompt multidisciplinary management involving transfusions, critical care, and organ support led to full maternal recovery. Conclusion: This case highlights the importance of early recognition and aggressive multidisciplinary intervention in life-threatening obstetric emergencies. Even in complex scenarios involving IUD and MODS, favourable maternal outcomes are achievable with timely and evidence-based care.