Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and HELLP syndrome

Kongwattanakul, Kiattisak; Saksiriwuttho, Piyamas; Chaiyarach, Sukanya; Thepsuthammarat, Kaewjai

doi:10.2147/ijwh.s168569

Cited by 93 publications

(65 citation statements)

References 18 publications

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“…6,[11][12][13][14] Early-onset PE has a lower incidence than late-onset PE, with a frequencies reported to be 0.5% and 1.4 to 1.7%, respectively. 5,6,14,15 Preeclampsia can also be classified as preterm or term, according to whether delivery is needed before or after 37 weeks of gestation. 1,6,16 An impaired placentation is thought to be the underlying cause of PE, with complete resolution of the clinical manifestations within 12 weeks postpartum.…”

Section: Introductionmentioning

confidence: 99%

Screening for Preeclampsia in the First Trimester and Aspirin Prophylaxis: Our First Year

Lourenço

Gomes

Ribeiro

et al. 2020

Rev Bras Ginecol Obstet

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Objective Preeclampsia is a major cause of perinatal and maternal morbidity and mortality. Our objective is to assess the performance of a combined screening test for preeclampsia in the first trimester and the prophylactic use of low-dose aspirin. Methods Prospective study of all women attending our hospital for the first-trimester screening of aneuploidies, between March 2017 and February 2018 (n = 1,297). The exclusion criteria were multiple pregnancy and major fetal abnormalities. Preeclampsia screening was performed with an algorithm that includes maternal characteristics, and biophysical and biochemical biomarkers. High-risk was defined as a risk ≥ 1:50 of early-onset preeclampsia (before 34 weeks), in which cases low-dose aspirin (150 mg at night) was offered to these women from screening until 36 weeks. Results From the 1,272 enrolled participants, the majority were Caucasian (1,051; 82.6%) and multiparous (658, 51.7%). Fifty patients (3.9%) screened high-risk for preeclampsia, and all started a low-dose aspirin regimen, with good compliance (96%). Early-onset preeclampsia was found in 3 pregnant women (0.24%), and total preeclampsia was diagnosed in 25 (2.02%), compared with 28 (0.75%) cases of early preeclampsia (p = 0.0099) and 98 (2.62%) of total preeclampsia (p = 0.2904) before the implementation of screening. Conclusion There was a lower incidence of both, early-onset and total preeclampsia, after the introduction of universal screening and prophylactic use of low-dose aspirin. This reduction was statistically significant in early-onset preeclampsia. The association of a first-trimester combined screening model and aspirin prophylaxis appears to be useful in predicting and reducing the incidence of early-onset preeclampsia, in a routine care setting.

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Section: Introductionmentioning

confidence: 99%

Screening for Preeclampsia in the First Trimester and Aspirin Prophylaxis: Our First Year

Lourenço

Gomes

Ribeiro

et al. 2020

Rev Bras Ginecol Obstet

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“…(Waterstone et al (7) published that incidence of HELLP syndrome was 0.5/1000 deliveries (95 % CI 0.3-0.8) in South East Thames region . Kongwattanakul et al (14) wrote incidence of HELLP syndrome was 1.4/1000 deliveries in Thailand during years 2012-2016.…”

Section: Discussionmentioning

confidence: 98%

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

M¹,

Krištúfková²,

Némethová³

et al. 2019

BLL

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OBJECTIVE: Hemolysis, Elevated Liver Enzymes, Low Platelets syndrome (HELLP syndrome) is one of the actively haunted maternal morbidity through Slovak Obstetric Survey System (SOSS), the organisation for surveillance of severe maternal morbidity and mortality in Slovakia. METHODS: The questionaires were sent in 55 Obstetric Units in Slovakia. The analyzed and here presented data had been collected cases those happened in the period from 1.1.2012 till 31.12.2014. Controls were women from SR during observed years, who delivered without HELLP syndrome. RESULTS: The return rate of questionnaires was 89.67 %, thus covering 146 972 deliveries during the study period in Slovakia. The exact incidence of HELLP syndrome was 0.63/1000 deliveries (CI 95 % 0.51-0.78). Risk factors were age > 30 (OR = 1.63), nuliparous (OR = 2.96), pregnancy after assisted reproduction technology (OR = 8.29) and multiple pregnancy OR = 9.19). The mean gestation age at delivery was 33.8th weeks. Vaginal delivery was by 10 (10.8 %) patients with HELLP syndrome and in the 83 (89.2 %) patients pregnancy was terminated with acute caesarean section. There were reported 45 050 cases (30.7 %) of the caesarean section in the control group throughout the study period. CONCLUSION: The older age, nulliparity, multiple pregnancy and pregnancy after assisted reproduction techniques was identifi ed as a signifi cant risk factors of HELLP syndrome (Tab. 5, Fig. 1, Ref.

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“…These findings are in accordance with all of the studies compared with Yildrim et al 6 39 patients (70.9%) of HELLP needed transfusion of blood or blood products. 15 Tandon et al 2016 reported comparable low incidence of maternal mortality in preeclampsia group -0.9%, but the incidence of mortality in HELLP syndrome group was high (18.18%). 5…”

Section: Maternal Outcomementioning

confidence: 95%

Maternal and perinatal outcome in patients of preeclampsia with and without HELLP syndrome

Madge

Seth

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Preeclampsia is seen in about 5-10% of all pregnancies and HELLP Syndrome occurs in 6-12% of these patients. Both are known to increase maternal and perinatal morbidity. The study aims to provide a comprehensive view of these myriad outcomes in the mother and neonate both, in each of the groups. It also compares the incidence of such outcomes in mother and child, in preeclampsia only and in those complicated by HELLP syndrome.Methods: This prospective, observational, comparative study was conducted at a tertiary referral centre. 55 patients with preeclampsia were compared with 55 patients with HELLP syndrome. The relevant clinical features, laboratory investigations and the maternal and perinatal outcomes along with the incidence were studied and results analyzed.Results: Significant differences were observed in laboratory parameters and duration of ICU stay in patients with preeclampsia and patients with HELLP syndrome. Incidence of maternal complications and need for blood transfusion was greater in HELLP syndrome. Only marginal differences were observed in birth weight, NICU admission rates and neonatal mortality rates.Conclusions: HELLP syndrome is associated with increased maternal morbidity and mortality as compared to preeclampsia. Neonatal outcomes appear to be influenced; only marginally, by HELLP syndrome, nevertheless, their incidence is more than in preeclampsia. Aggressive treatment for pregnant women appears to decrease the maternal mortality rate.

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Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and HELLP syndrome

Cited by 93 publications

References 18 publications

Screening for Preeclampsia in the First Trimester and Aspirin Prophylaxis: Our First Year

Screening for Preeclampsia in the First Trimester and Aspirin Prophylaxis: Our First Year

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

Maternal and perinatal outcome in patients of preeclampsia with and without HELLP syndrome

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