Document Detail


Is there a diurnal pattern in the clinical symptoms of HELLP syndrome?
MedLine Citation:
PMID:  16581604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if there is a diurnal pattern in the clinical symptoms of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets) syndrome. STUDY DESIGN: A retrospective study was performed in 134 pregnancies complicated by HELLP syndrome. The medical records were reviewed to describe each HELLP episode. Time of day was divided into three periods, day, evening, and night. The following parameters were categorized according to the time of day: onset of symptoms, consultation by the doctor, initial blood sampling, diagnosis and decrease of symptoms. Biochemical parameters at clinical presentation and consecutive changes within 24 h were recorded. RESULTS: In 65 pregnancies 77 HELLP episodes were well documented. Times of onset of symptoms and consultation by the doctor were significantly higher during the evening and night (p < 0.001), whereas times of diagnosis and decrease of symptoms occurred significantly more during the day (p < 0.001). In only 49.3% of the cases were diagnostic laboratory criteria met at clinical presentation. This was mainly due to platelet values in excess of 100 x 10(9)/l. Several hours later (median 8 h, range 2-23) the decrease in platelets occurred. CONCLUSIONS: A diurnal pattern exists in the clinical symptoms of HELLP syndrome that is characterized by an exacerbation during the night and recovery during the day. There is a considerable delay between the onset of symptoms and the fulfillment of diagnostic laboratory criteria.
Authors:
Steven V Koenen; Anjoke J M Huisjes; Jules Dings; Yolanda van der Graaf; Gerard H A Visser; Hein W Bruinse
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  19     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-04-03     Completed Date:  2008-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-9     Citation Subset:  IM    
Affiliation:
Department of Perinatology and Gynaecology, University Medical Centre Utrecht, The Netherlands. svk4@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Circadian Rhythm*
Female
HELLP Syndrome / blood*,  epidemiology,  physiopathology*
Humans
Infant, Newborn
Male
Medical Records
Platelet Count
Pregnancy
Pregnancy Outcome / epidemiology
Referral and Consultation
Retrospective Studies
Stillbirth
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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