Document Detail


Factors affecting maternal and perinatal outcomes in HELLP syndrome: evaluation of 126 cases.
MedLine Citation:
PMID:  21077527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To ascertain the characteristics, clinical features, and maternal fetal outcome in HELLP (hemolysis elevated liver enzymes, low platelets) syndrome at a tertiary referral center.
MATERIAL AND METHODS: This was a cross-sectional study carried out at Dicle University between January 2004 and December 2008 in which the charts of 126 cases were retrieved retrospectively and data analyzed descriptively.
RESULTS: Of all deliveries 0.9% were complicated by HELLP syndrome. Of the cases with HELLP syndrome 79 (62.6%) had preeclampsia, 28 (22.2%) had eclampsia and 19 (15.2%) had a diagnosis of HELLP syndrome. The values of significant biochemical parameters (mean +/- SD) were documented as ALT (alanin aminotransferase) 224 +/- 42 IU/I and ALT1 (after birth) 140 +/- 22, AST 379 +/- 23 IU/l and AST1 215 +/- 51, LDH (lactate dehydrogenase) 1418 +/- 67 IU/l and LDH1 875 +/- 16, together with the hematological parameters as platelet count (86 +/- 12 K/Ul), urine protein (3 + in urine test stick) and albumin levels (2 + 0.9 g/dl). Eighty-six (68.25%) of the patients required albumin replacement. Thirty-one (24.6%) cases were nullipara and 95 (75.4%) multipara; of which 32 women (25.4%) were in Class I, and 94 (74.6 %) in Class II of complete HELLP syndrome. Regular antenatal examination was accomplished in a very small number of patients (12.25%). Fifty-eight (46.03%) patients required transfusions with blood or blood products and 12 (9.5%) underwent laparotomy due to major intraabdominal bleeding. Magnesium sulphate to prevent convulsions and corticosteroids (12 mg betametazone) to enhance fetal lung maturity were administered. Forty-four (34.9%) cases had vaginal delivery and 82 (65.1%) cesarean section; another 18 (14.2%) were with in utero stillbirth. Fifteen babies (11.9%) died, 26 (20.63%) developed placental abruption, 14 (11.11%) acute renal insufficiency, and 13 (10.31%) postoperative subcutaneous hematomas. Maternal mortality occurred in ten cases (7.93%).
CONCLUSION: HELLP syndrome is a pathology associated with a high incidence of maternal and perinatal complications. Laboratory parameters in cases with HELLP syndrome are not efficient in detecting perinatal results, but can be used as risk denominators in evaluating maternal complications. Therefore, for patients with HELLP syndrome, standard antenatal follow-up protocols should be applied in order to obtain early diagnosis and improve the speed of transfer to obstetric departments with expertise in this field.
Authors:
M Erdemoğlu; U Kuyumcuoğlu; A Kale; N Akdeniz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental obstetrics & gynecology     Volume:  37     ISSN:  0390-6663     ISO Abbreviation:  Clin Exp Obstet Gynecol     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-16     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802110     Medline TA:  Clin Exp Obstet Gynecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  213-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Dicle University Medical School, Diyarbakir, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / epidemiology
Acute Kidney Injury / epidemiology
Adolescent
Adult
Anticonvulsants / therapeutic use
Apgar Score
Betamethasone / therapeutic use
Birth Weight
Blood Transfusion / statistics & numerical data
Cesarean Section / statistics & numerical data
Cross-Sectional Studies
Eclampsia / epidemiology
Female
Glucocorticoids / therapeutic use
HELLP Syndrome / epidemiology*
Hematoma / epidemiology
Humans
Infant, Newborn
Lung / embryology
Magnesium Sulfate / therapeutic use
Middle Aged
Pregnancy
Retrospective Studies
Stillbirth / epidemiology
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Glucocorticoids; 378-44-9/Betamethasone; 7487-88-9/Magnesium Sulfate

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