HELLP syndrome: Understanding and management of a pregnancy-specific disease

Abstract

HELLP, a syndrome characterised by haemolysis, elevated liver enzymes and low platelets, a variant of pre-eclampsia/eclampsia, is a multisystemic disorder with an incidence of up to 0.9% in all pregnancies and occurs in about one-quarter of pre-eclamptic patients. Most obstetricians presume that HELLP derives from an autoimmune reaction, leading to a materno- fetal imbalance, with accompanying aggregation of platelets, endothelial malfunction along with inborn errors of fatty acid oxidative metabolism. HELLP is characterised by high mortality and morbidity rates, leading to possibly life-threatening complications regarding both the mother and the fetus. Delivery is indicated if HELLP syndrome occurs after 34 gestational weeks or the fetal and/or maternal conditions deteriorate. Vaginal delivery is preferable. Standard corticosteroid treatment is of uncertain clinical value in maternal HELLP syndrome. Future observations and research results may shed more light on improving our understanding of the aspects of HELLP syndrome.

Risk Factors, Management, and Outcomes of Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Elevated Liver Enzymes, Low Platelets Syndrome

“…7,15 There may be a number of reasons for this difference, including variable and inconsistent diagnostic criteria 3 ; we used a case definition comparable to the strict criteria proposed by Sibai et al 3,16 Other methodologic differences may also explain our lower incidence estimates. 7,15 There may be a number of reasons for this difference, including variable and inconsistent diagnostic criteria 3 ; we used a case definition comparable to the strict criteria proposed by Sibai et al 3,16 Other methodologic differences may also explain our lower incidence estimates.…”

The Role of Statins in Prevention of Preeclampsia: A Promise for the Future?

“…Other signs and symptoms that accompany the disease include: headache, visual disturbances, epigastric or abdominal pain, weakness, altered mental status, HELLP syndrome (Aloizos et al, 2013) dyspnea and edema (American College of Obstetricians and Gynecologists and Task Force on Hypertension in Pregnancy, 2013). Many factors have been found to increase the risk of preeclampsia and their association with the disease has been adequately elucidated.…”

Hellp sendromu tanısı alan hastaların maternal ve fetal sonuçlarının analizi

“…Respiratuar distres sendromu (RDS) 20 (26,3) Prematüre retinopatisi (ROP) 5 (6,5) Nekrotizan enterokolit (NEK) 6 (7,8) Sepsis 3 (3,9)…”

“…Maternal ve fetal iyilik durumunun ani ve çoğu zaman da hızlı şekilde bozulması ile karakterizedir. Maternal mortalite %1-3, perinatal mortalite ise %35 oranında bildirilmiştir [3][4][5]. Çalışmamızda HELLP sendromu tanısı ile takip edilmiş olan hastalarımızın demografik özellikler ve laboratuvar verileri retrospektif olarak incelenerek maternal ve perinatal sonuçları etkileyen risk faktörlerinin değerlendirilmesi planlandı.…”