Maternal mortality associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome

Isler, Christy; Rinehart, Brian K.; Terrone, Dom A.; Martin, Rick W.; Magann, Everett F.; Martin, James N.

doi:10.1016/s0002-9378(99)70343-1

Cited by 154 publications

(91 citation statements)

References 18 publications

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“…Three patients developed wound hematoma after cesarean section, and the condition is said to be more common in patients with HELLP syndrome. There were no neurological complications associated with HELLP syndrome in this study, while Isler et al [8] have reported serious intracerebral hemorrhage in these patients. Severe postpartum bleeding was seen in two cases and forms an important complication to anticipate in these patients.…”

Section: Discussioncontrasting

confidence: 48%

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HELLP or Help: A Real Challenge

Chawla

Marwaha

Agarwal

2014

J Obstet Gynecol India

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Objectives To ascertain the prevalence, presentation, diagnosis, severity, and complications of HELLP syndrome. Materials and Methods This is a prospective observational study analyzing the conditions and the data of 24 cases of HELLP syndrome in a tertiary care hospital. The analysis was done for the demographic characteristics, presentation of these patients, complications associated, and the perinatal outcome. Results 0.45 % of the patients admitted for delivery developed HELLP syndrome. Majority of the patients developed the condition in 30-36 weeks period of gestation, while five patients developed it in the postpartum period. The condition led to 12.5 % of maternal and 45.8 % of perinatal mortality.Conclusion HELLP syndrome is an important cause for maternal and perinatal morbidity and mortality.

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Section: Discussioncontrasting

confidence: 48%

“…Maternal mortality, up to 25 %, has been reported with Creatinine (mg %) 0.98 ± 0.53 0. 6-3.3 HELLP [7][8][9]. Our study had maternal mortality of 12.5 %.…”

Section: Discussionmentioning

confidence: 82%

HELLP or Help: A Real Challenge

Chawla

Marwaha

Agarwal

2014

J Obstet Gynecol India

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“…Stroke is the most common cause of death in patients with the HELLP syndrome. 3,[5][6][7]10,14,17,21) The mechanisms underlying the HELLP syndrome are poorly understood, but arterial spasms induced by abnormal release of vasoactive agents are thought to be involved. 4,17) However, nontraumatic intracerebral hemorrhage in a young patient is usually associated with vascular anomalies such as arteriovenous malformation or venous malformation, or with neoplasm or embolism.…”

Section: Discussionmentioning

confidence: 99%

“…1,21) HELLP syndrome manifests as various clinical features such as malaise, jaundice, upper abdominal pain, nausea, vomiting, renal failure, disseminated intravascular coagulation (DIC), pulmonary edema, abruptio placentae, and even rupture of the liver. 2,7,10,14,17,21) Stroke involving cerebral vasospasm frequently complicates HELLP syndrome and severe eclampsia. 3,6,8,12,19) We report a patient with intracerebral hemorrhage associated with HELLP syndrome in whom hematoma evacuation was unexpectedly followed by late diffuse cerebral swelling.…”

Section: Introductionmentioning

confidence: 99%

Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome. Case Report.

Hashiguchi

Inamura

Irita

et al. 2001

Neurol. Med. Chir.(Tokyo)

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Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome can occur at any time in the course of pregnancy and is associated with many complications including fatal stroke. A 37-yearold female presented with HELLP syndrome causing an intracerebral hematoma, which was treated by evacuation and mild hypothermia. Unexpected diffuse cerebral swelling occurred on the 15th day of the initially favorable postoperative course. Considerable impairment of consciousness persisted despite conservative therapy. Serial computed tomographic findings indicated delayed cerebral vasospasm as the cause of the swelling. Particularly careful management is required even beyond the first 2 weeks for patients with stroke as a complication of HELLP syndrome.

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“…21 Furthermore, disseminated intravascular coagulation may occur with HELLP syndrome in up to 39% of patients. 22 Compared to PDPH, the headache of intracranial hematoma is associated with focal neurological abnormalities and signs of increased intracranial pressure (ICP) such as confusion and vomiting. Seizures induced by an increased ICP may be misinterpreted as eclampsia.…”

Section: Figure Brain Magnetic Resonance Imaging Showing Bilateral Tementioning

confidence: 99%

Intracranial subdural hematoma following dural puncture in a parturient with HELLP syndrome

Ezri

Abouleish²,

Lee³

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To present a case of postpartum bilateral intracranial subdural hematoma after dural puncture during attempted epidural analgesia for labour.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : This complication occurred following accidental dural puncture in a parturient with thrombocytopenia (99,000·µL -1 ) who subsequently developed the syndrome of hemolysis, elevated liver enzymes and low platelets. On the first postoperative day, postdural puncture headache (PDPH) developed. An epidural blood patch (EBP) was deferred to the third postoperative day because of a platelet count of 21,000·µL -1 . However, the headache intensified from a typical PDPH to one which was not posturally related. A second EBP was abandoned after the injection of 5 mL of blood because of increasing headache during the procedure. Magnetic resonance imaging revealed bilateral temporal subdural hematomas. The patient was managed conservatively and discharged home without any sequelae.

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Maternal mortality associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome

Cited by 154 publications

References 18 publications

HELLP or Help: A Real Challenge

HELLP or Help: A Real Challenge

Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome. Case Report.

Intracranial subdural hematoma following dural puncture in a parturient with HELLP syndrome

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