Fetomaternal outcome in women with hemolysis, elevated liver enzymes and low platelet count syndrome: a retrospective study

Authors

  • M. B. Divya Department of Obstetrics and Gynecology, Government Medical College, Thrissur, Kerala, India http://orcid.org/0000-0002-9037-3024
  • Nishi Roshini Kondakasseril Department of Obstetrics and Gynecology, Government Medical College, Thrissur, Kerala, India
  • Mekkattukunnel Andrews Andrews Department of Medicine, Government Medical College, Thrissur, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20203859

Keywords:

Hemolysis elevated liver enzymes and low platelet count, Maternal morbidity, Maternal mortality, Perinatal morbidity perinatal mortality, Preeclampsia

Abstract

Background: HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome which is a variant form of severe preeclampsia is an important cause of maternal and fetal mortality and morbidity. The importance lies in the early diagnosis and timely intervention for better fetal and maternal outcome. The objective of this study was to assess the maternal and fetal outcome in pregnancies complicated with HELLP syndrome.

Methods: This is a retrospective study analyzing fetomaternal outcome in 63 women diagnosed with HELLP syndrome in the department of obstetrics and gynecology, Government Medical College, Thrissur from 1st January 2014 to 31st December 2016. Details were collected from data records library.

Results: Among 7,566 deliveries, 63 women (0.83%) had HELLP syndrome. Mean age was 29.5 years. 47.6% (n=30) women developed HELLP syndrome at gestational age less than 34 weeks. Maternal complications were abruption (27.78%), acute kidney injury (16.67%), DIC (16.67%), sepsis (11.11%) and postpartum hemorrhage (11.11%). In this study, HELLP syndrome lead to one maternal death (1.58%). The perinatal mortality was 25.75%.

Conclusions: HELLP syndrome is an alarming complication, which brings high maternal and perinatal morbidity and mortality.

References

Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics 25th ed. Mcgraw-hill; 2018:722-723.

American College of Obstetrics and Gynecologists. Taskforce on hypertension in pregnancy. hypertension in pregnancy/developed by the taskforce on hypertension in pregnancy. ACOG; 2013:34

Chawla S, Marwaha A, Agarwal R. HELLP or help: a real challenge. J Obstet Gynecol India. 2015;65(3):172-5.

Campos AC. HELLP syndrome, a severe form of preeclampsia: a comparative study of clinical and laboratorial parameters. Am J Experiment Clin Res. 2016;3(3):170-4.

Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169(4):1000-6.

Kota LN, Garikapati K, Kodey PD, KB G. Study on HELLP syndrome-maternal and perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):715.

Isler CM, Rinehart BK, Terrone DA, Martin RW, Magann EF, Martin JN. Maternal mortality associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynecol. 1999;181(4):924-8.

Fitzpatrick KE, Hinshaw K, Kurinczuk JJ, Knight M. Risk factors, management, and outcomes of hemolysis, elevated liver enzymes, and low platelets syndrome and elevated liver enzymes, low platelets syndrome. Obstet Gynecol. 2014;123(3):618-27.

Gasem T, Al Jama FE, Burshaid S, Rahman J, Al Suleiman SA, Rahman MS. Maternal and fetal outcome of pregnancy complicated by HELLP syndrome. J Maternal-Fetal Neonat Med. 2009;22(12):1140-3.

Haddad B, Barton JR, Livingston JC, Chahine R, Sibai BM. Risk factors for adverse maternal outcomes among women with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Am J Obstet Gynecol. 2000;183(2):444-8.

Van Pampus MG, Wolf H, Westenberg SM, van der Post JA, Bonsel GJ, Treffers PE. Maternal and perinatal outcome after expectant management of the HELLP syndrome compared with pre-eclampsia without HELLP syndrome. Eu J Obstet Gynecol Reprod Biol. 1998;76(1):31-6.

Downloads

Published

2020-08-27

Issue

Section

Original Research Articles