A comparative study of co-morbidities and outcomes between HELLP syndrome and severe pre-eclampsia without HELLP syndrome in a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250504Keywords:
HELLP syndrome, Maternal and perinatal outcome, Pre-eclampsiaAbstract
Background: Pre-eclampsia is a pregnancy specific, multi-system, life-threatening complication. Incidence of severe pre-eclampsia varies between 10-20% of all pregnancies and that of HELLP syndrome is 0.2-0.6% of all pregnancies. This study aims to provide a comprehensive view of maternal and perinatal outcomes in HELLP syndrome and that of severe pre-eclampsia without HELLP.
Methods: This prospective, observational, comparative study was conducted at a tertiary care centre- Grant medical college and sir JJ group of hospitals, in a period of 10 months (March 2024 to December 2024). 30 patients of pre-eclampsia with severe features were compared with 30 patients of HELLP syndrome. The maternal and perinatal outcomes were studied and results analysed.
Results: Incidence of maternal complications and the need for blood and blood products transfusion was greater in HELLP syndrome. However, only marginal differences were noted in the perinatal outcomes.
Conclusions: HELLP syndrome is associated with increased maternal morbidity and mortality as compared to severe pre-eclampsia. Only marginal differences were noted in neonatal outcomes due to HELLP syndrome and severe preeclampsia without HELLP syndrome. Aggressive and timely treatment of these maternal conditions helps in reducing the maternal morbidity and mortality.
Metrics
References
Baylis A, Zhou W, Menkhorst E, Dimitriadis E. Prediction and prevention of late-onset pre-eclampsia: a systematic review. Frontiers in medicine. 2024;11:1459289. DOI: https://doi.org/10.3389/fmed.2024.1459289
Arias F, Bhide AG, Arulkumaran S, Damania K, Daftary SN, editors. Practical Guide to High Risk Pregnancy and Delivery-E-Book: A South Asian Perspective. Elsevier health sciences. 2008: 15.
Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. American J Obst and Gynecology. 1982;15(2):159-67. DOI: https://doi.org/10.1016/S0002-9378(16)32330-4
Misra R. Ian Donald’s Practical Obstetrics Problems, 9/e. Wolters kluwer india Pvt Ltd. 2020.
Karrar SA, Martingano DJ, Hong PL. Preeclampsia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97-104. DOI: https://doi.org/10.1016/j.preghy.2014.02.001
Vinnars MT, Wijnaendts LC, Westgren M, Bolte AC, Papadogiannakis N, Nasiell J. Severe preeclampsia with and without HELLP differ with regard to placental pathology. Hypertension. 2008;51(5):1295-9. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.107.104844
Turgut A, Demirci O, Demirci E, Uludoğan M. Comparison of maternal and neonatal outcomes in women with HELLP syndrome and women with severe preeclampsia without HELLP syndrome. J Prenat Med. 2010;4(3):51-8.
Tandon A, Chaudhari P, Gupta V, Ramola M. Feto-maternal outcome in HELLP and partial HELLP syndrome. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3066-71. DOI: https://doi.org/10.18203/2320-1770.ijrcog20162986
MadgeH, Seth S. Maternal and perinatal outcome in patients of preeclampsia with and without HELLP syndrome. Int J Reprod Contracept Obstet Gynecol.2019;8:2065-70. DOI: https://doi.org/10.18203/2320-1770.ijrcog20191968
Ascoglu O, Gungorduk K, Yildirim G, Aslan H, Gunay T. Maternal and perinatal outcomes of eclampsia with and without HELLP syndrome in a teaching hospital in western Turkey. J Obstet Gynaecol (Lahore). 2014;34:326-31. DOI: https://doi.org/10.3109/01443615.2014.881791
Chawla S, Marwaha , Agarwal R. HELLP or Help: A Real Challenge. J Obstet Gynecol India. 2015;65(3)172-5. DOI: https://doi.org/10.1007/s13224-014-0582-8
Kim HY, Sohn YS, Lim JH, Kim EH, Kwon JY, Park YW, et al. Neonatal outcome after preterm delivery in HELLP syndrome. Yonsei Med J. 2006;47(3):393-8. DOI: https://doi.org/10.3349/ymj.2006.47.3.393
Kongwattanakul K, Saksiriwuttho P, Chaiyarach S, Thepsuthammarat K. Incidence, characteristics, maternal complications and perinatal outcomes associated with preeclampsia with severe features and HELLP syndrome. Int J Womens Health. 2018;10:371-7. DOI: https://doi.org/10.2147/IJWH.S168569
Gul A, Cebeci A, Aslan H, Polat I, Ozdemir A, Ceylan Y. Perinatal outcomes in severe preeclampsia-eclampsia with and without HELLP syndrome. Gynecol Obstet Invest. 2005;59(2):113-8. DOI: https://doi.org/10.1159/000082648