HELLP syndrome in eclampsia and its impact on maternal and foetal outcome: a study in a tertiary care centre of rural India

Shibram Chattopadhyay, Amitava Pal, Rupali Modak, Tapan Kr. Maity, Shritanu Bhattcharya


Background: Objective of current study was to determine the incidence of HELLP syndrome in patients with eclampsia and its impact on maternal and perinatal outcome.

Methods: The prospective study was conducted in the department of obstetrics and gynaecology, Burdwan medical college, Burdwan on 727 eclamptic mothers, admitted from January 2012 to December 2013. Clinical data and detailed investigations including complete haemogram, liver function tests and relevant investigations for haemolysis were analysed. Statistical analysis was performed using student’s t-test and χ2 test where appropriate. All P values <0.05 were considered statistically significant.

Results: The incidence of HELLP syndrome among the women of eclamptic mothers was 7.43% (54/727). Among 54 patients; abruptio placentae (12.96%), acute renal failure (11.11%) and cerebral haemorrhage (11.11%) were most frequent maternal complications followed by DIC (3.70%). Maternal and perinatal mortality in HELLP syndrome were 7.40% and 30.5% respectively. SGOT level was higher in complete HELLP and it is statistically significant when compared to incomplete variant (P <0.0004). Complete HELLP syndrome is at increased risk for serious complications when compared to incomplete variety.  

Conclusions: Classification of HELLP syndrome cases according to the clinical and laboratory findings can help in the monitoring and treatment of the disease.to improve perinatal outcome without increasing maternal morbidity.


HELLP syndrome, Maternal outcome, Foetal outcome

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Kawabata I, Nakai A, Takeshita T. Prediction of HELLP syndrome with assessment of maternal dual hepatic blood supply by using Doppler ultrasound. Arch Gynaecol Obstet. 2006;274:303-9.

Weinstein L. Syndrome of haemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension. Am J Obstet Gynaecol. 1982;142:159-67.

Ott J, Poschalko, Zeisler H. Severe early onset haemolysis, elevated liver enzyme, and low platelet -syndrome in 2 subsequent pregnancies: case report and review of the literature. Arch Gynaecol Obstet. 2010;281:265-8.

Vigil-De Gracia P. Pregnancy complicated by pre-eclampsia-eclampsia with HELLP syndrome. Int J Obstet Gynaecol. 2001;72:17-23.

Barton JR, Sibai BM. Diagnosis and management of haemolysis, elevated liver enzyme, and low platelets syndrome. Clin Perinatol. 2004;31:807-33.

Pokharel SM, Chattopadhyay SK, Jaiswal R, Shakya P. HELLP syndrome: a pregnancy disorder with poor prognosis. J Nepal Med Coll. 2008;10:260-3.

Sibai BM. Maternal morbidity and mortality in 442 pregnancies with haemolysis elevated liver enzyme, and low platelets (HELLP Syndrome). Am J Obstet Gynaecol. 1993;169:1000-6.

Yucesoy G, Yigit C, Bodur H, OzkanS, Tan T. An analysis of HELLP syndrome cases: does platelet count predict adverse maternal and fetal outcome in women with HELLP syndrome? Arch Gynaecol Obstet. 2011;283:941-5.

Banoo S, Makhdoomi TA, Mir S, Malik JA. Incidence of HELLP syndrome in severe pregnancy induced hypertension and its impact on maternal and fetal outcome. JK Practitioner. 2007;14:92-4.

Audibert F, Friedman SA, Frangieh AY, Sibai BM. Clinical utility of strict diagnostic criteria for the HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynaecol. 1996;175:460-4.

Young-quing W, Jing W, Rong-hua YE, Yang-yu Z. Investigation of diagnosis and treatment of haemolysis-elevated liver enzyme-low platelet counts (HELLP syndrome: clinical analysis 59 cases. Chinese Med J. 2010;123:1273-7.

Sibai BM. Diagnosis, controversies, and management of the syndrome of haemolysis, elevated liver enzymes, and low platelet count. Obstet Gynaecol. 2004;103:981-91.