HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: Onset at ≤28.0 weeks’ gestation

Haddad, Bassam; Livingston, Jeffrey; Chahine, Rabih; Sibai, Bahaeddine M

doi:10.1067/mob.2000.106975

Cited by 63 publications

(66 citation statements)

References 15 publications

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“…Other adverse maternal outcome rates were similar in both disorders (11) showed that the eclampsia rate was higher in HELLP syndrome cases than in severe preeclampsia between 24 and 32 weeks of gestation. However, another study found similar eclampsia rates in both groups and the requirement for blood products transfusions was higher in HELLP syndrome than in severe preeclampsia in cases at <28 weeks' gestation (8).…”

Section: Discussionmentioning

confidence: 97%

“…Maternal age, gravidity, parity, gestational age at delivery, and mean arterial blood pressure were similar in both disorders. However, Haddad et al (8) showed that severe preeclampsia cases were younger than HELLP syndrome cases and another study found lower gestational age at delivery in HELLP syndrome cases (7).…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have also shown that maternal morbidity risk is higher in HELLP syndrome cases than in severe preeclampsia (5)(6). In other studies, no significant difference was found for the maternal and perinatal outcomes between the two disorders (7)(8).…”

mentioning

confidence: 91%

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Severe Preeclampsia versus HELLP Syndrome: Maternal and Perinatal Outcomes at <34 and ≥34 Weeks’ Gestation

Kinay¹,

Kucuk²,

Kayıkçıoğlu³

et al. 2015

Balkan Med J

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Background: Preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP) syndrome are important disorders affecting the health of both the mother and fetus. Prediction of the maternal and perinatal outcomes at early and late gestational age is important for the management of both disorders. Aims: The purpose of the study was to investigate adverse maternal and perinatal outcomes in severe preeclampsia and HELLP syndrome cases according to gestational age. Study Design: Retrospective cross-sectional study. Methods: One hundred and ninety-seven pregnancies with severe preeclampsia and 56 pregnancies with HELLP syndrome were included the study. Clinical characteristics and adverse maternal and perinatal outcomes were noted from medical records. Participants were divided into two groups at <34 and ≥34 weeks' gestation: the severe preeclampsia group and the HELLP syndrome group. The differences between the outcomes in the groups were investigated. Statistical analysis was performed using the Student t test, Fisher Exact test and Yates' Chi-square test. Results: Eclampsia was more common in HELLP syndrome cases at <34 weeks' gestation (p 0.028). However, eclampsia rates were statistically similar between groups at ≥34 weeks' gestation. The requirement for blood products transfusion was higher in the HELLP group at all gestational weeks. No statistical difference was found in perinatal outcomes between severe preeclampsia and HELLP groups at less than and more than 34 weeks' gestation. Conclusion: Eclampsia risk increases in HELLP syndrome, especially at gestations less than 34 weeks. Perinatal morbidity at less than 34 weeks' gestation and mortality were similar in severe preeclampsia and HELLP syndrome cases at the same gestational age.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Severe Preeclampsia versus HELLP Syndrome: Maternal and Perinatal Outcomes at <34 and ≥34 Weeks’ Gestation

Kinay¹,

Kucuk²,

Kayıkçıoğlu³

et al. 2015

Balkan Med J

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“…AKI occurs in 3%-15% of cases of HELLP syndrome, and HELLP syndrome accounts for 40% of all cases of P-AKI and up to 60% of severe cases (13,(63)(64)(65). AKI associated with HELLP syndrome, even in its severe forms requiring dialysis, usually retains a favorable renal outcome.…”

Section: Tma In Pregnancy: the Great Paradigm Shiftmentioning

confidence: 99%

Obstetric Nephrology

Fakhouri

Vercel

Frémeaux‐Bacchi

2012

Clinical Journal of the American Society of Nephrology

147

121

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Summary AKI in pregnancy remains a cause of significant fetomaternal mortality and morbidity, particularly in developing countries. Hypertensive complications of pregnancy (preeclampsia/eclampsia or hemolysis, elevated liver enzymes, and low platelets count syndrome) are the leading cause of AKI in pregnancy worldwide. Thrombotic microangiopathy is another peculiar and devastating cause of AKI in pregnancy. During the last decade, our understanding, and in some cases, our management, of these causes of AKI in pregnancy has dramatically improved. For instance, convincing data have linked pre-eclampsia/eclampsia to an increase in circulating antiangiogenic factors soluble Flt 1 and endoglin, which induce endothelial cell dysfunction, hypertension, and proteinuria. Several distinct pathogenic mechanisms underlying thrombotic microangiopathy, including thrombotic microangiopathy occurring during pregnancy, have been established. Thrombotic microangiopathy, which can present as hemolytic uremic syndrome or thrombotic thrombocytopenic purpura, can be reclassified in four potentially overlapping subtypes: disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 deficiency-related thrombotic microangiopathy, complement alternative pathway dysregulation-related thrombotic microangiopathy, secondary thrombotic microangiopathy (verotoxin and antiangiogenic drugs), and thrombotic microangiopathy of undetermined mechanism. In most cases, pregnancy is only a precipitating factor for thrombotic microangiopathy. Treatment of thrombotic microangiopathy occurring during pregnancy should be tailored to the underlying pathogenic mechanism: (1) restoration of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 serum activity in the setting of thrombotic thrombocytopenic purpura through plasma exchanges and in some cases, B cell-depleting therapy and (2) inhibition of complement alternative pathway activation in atypical hemolytic uremic syndrome using antiC5 blocking antibody (eculizumab).

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“…Haddad ve ark. [12] ise HELLP sendromlu hastalarda trombositopeni mevcudiyetinin maternal komplikasyonları arttırdığını, ancak AST ve LDH seviyesindeki artışların maternal komplikasyonlar ile ilişkili olmadığını tespit etmişlerdir. Kumru [13] trombositin < 70.000 l/mm3, AST'nin > 400 IU/L, ALT'nin > 400 IU/L, kreatinin > 2 mg/dl olmasının kötü maternal sonuç ile ilişkili olabileceğini belirtmiş-lerdir.…”

Section: Perinatal Komplikasyonlar N (%)unclassified