Neonatal morbidity and mortality associated with maternal haemolysis elevated liver enzymes and low platelets syndrome

Dötsch, Jörg; Hohmann, M.; Kühl, Peter

doi:10.1007/s004310050621

Cited by 30 publications

(26 citation statements)

References 8 publications

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“…Data regarding neonatal BP in infants born to mother with HELLP are scarce. We are aware of one study showing HELLP to be associated with a higher need for volume expansion and a trend toward more hypotension on day 1 in preterm infants (39). Our results point in the same direction and may provide a link between HELLP syndrome and adverse outcome in preterm infants (40), although data concerning the latter are conflicting.…”

Section: Discussionsupporting

confidence: 58%

Early Postnatal Blood Pressure in Preterm Infants: Effects of Chorioamnionitis and Timing of Antenatal Steroids

et al. 2009

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Previous studies suggest postnatal blood pressure in preterm infants to be decreased by chorioamnionitis and increased by antenatal steroids (AS). We examined the adjusted effects of both antenatal modulators on postnatal blood pressure (BP), with separate effects reported for histologic chorioamnionitis with or without fetal involvement and timing of AS. General characteristics, BP, and heart rate values during the first 72 h after birth were obtained from 271 infants with gestational age Յ32.0 wk. In unadjusted analyses, chorioamnionitis was associated with lower BP, most prominently so in infants with fetal involvement, without an effect on hypotension incidence. AS increased BP and decreased the incidence of hypotension when administered within 7 d before birth. In a multivariable mixed model analysis, the AS effect remained significant, whereas chorioamnionitis was not independently predictive of postnatal BP. Other variables associated with increased postnatal BP were gestational age and umbilical artery pH, whereas hemolysis, elevated liver enzymes, low platelets syndrome was associated with decreased BP.

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Section: Discussionsupporting

confidence: 58%

Early Postnatal Blood Pressure in Preterm Infants: Effects of Chorioamnionitis and Timing of Antenatal Steroids

et al. 2009

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“…Dötsch et al [18] reported that before 32 weeks of gestation, both respiratory and cardiovascular morbidity and IUGR associated with preeclampsia are further aggravated by a maternal HELLP syndrome.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Outcome in Pregnancies after Preterm Delivery for HELLP Syndrome

Aslan¹,

Gül²,

Cebeci³

2004

Gynecol Obstet Invest

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Objective: To compare neonatal outcome after preterm delivery of infants where pregnancy had been complicated by the HELLP syndrome. Study Design: The maternal and neonatal charts of 475 consecutive pregnancies complicated by hypertensive disorders at our perinatal unit were reviewed. The HELLP syndrome was defined by previously published laboratory criteria. 93 women fulfilled the criteria and constituted our HELLP syndrome study group. 188 normotensive patients who were delivered because of preterm labor comprised the control group. Results were compared by means of χ² analysis and Student’s t test where appropriate. Results: There were 518 pregnancies complicated by hypertensive disorders and 93 by HELLP syndrome. The incidence of HELLP syndrome among women with severe preeclampsia was 19.5%. We found a significant difference in the incidence of intrauterine growth restriction (61.2 vs. 5.8%, p < 0.0001), intrauterine fetal death (13.9 vs. 6.9%, p = 0.035), abruptio placenta (13.9 vs. 2.6%, p = 0.001), and fetal distress (35.4 vs. 12.2%, p < 0.0001) between the two groups. There were no significant differences in complications (respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and sepsis) between the HELLP syndrome group and controls. However, the neonatal death rate and the need for mechanical ventilation and neonatal intensive care were greater in the HELLP syndrome group. Conclusions: Our study suggests an increased mortality and morbidity in newborns of mothers complicated with HELLP syndrome that can be partly attributed to increased rates of intrauterine growth restriction and fetal distress, particularly beyond 32 weeks of gestation.

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“…Two studies have suggested that severe maternal preeclampsia is associated with a high incidence of neonatal hypotension. 19,20 Those studies did not exclude the possibility that the increased incidence of neonatal hypotension in infants born to mother with preeclampsia might have resulted from lower birth weight or fetal exposure to magnesium sulfate. Nonetheless, preeclampsia is an attractive primary etiology of neonatal hypotension as preeclampsia tends to cause intrauterine growth retardation and to result in fetal exposure to magnesium sulfate.…”

Section: Discussionmentioning

confidence: 99%

“…10 Other investigators have linked neonatal hypotension to an increased risk of central nervous system morbidities, such as intraventricular hemorrhage, 11,12 white matter injury, 13 poor neurodevelopmental outcome 14,15 and threshold retinopathy of prematurity. 16 The etiology of neonatal hypotension is likely multifactorial, 17,18 but recently severe preeclampsia 19,20 has been suggested to be a contributing factor. These studies did not define the diagnostic criteria for neonatal hypotension, nor the age of diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Early neonatal hypotension in premature infants born to preeclamptic mothers

Sharma

et al. 2006

J Perinatol

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Background: Early neonatal hypotension (ENH) is common in premature infants and has been claimed to occur more frequently in infants born to mothers with severe preeclampsia. Previous studies that showed a relationship between maternal preeclampsia and neonatal hypotension did not control for potential confounding factors such as birth weight and maternal treatment with magnesium sulfate (MgSO 4 ).Objective: To determine whether maternal preeclampsia is an independent risk factor for ENH.Study Design: We conducted a retrospective review of all viable singleton infants with gestational age of 23 to 30 weeks who were admitted to the neonatal intensive care unit over a 2-year period. ENH was defined as the persistence of the mean arterial pressure lower than the gestational age in weeks requiring volume expansion and inotropic support in the first 24 h of life.Results: One hundred and eighty four infants were enrolled. Seventy-five (41%) infants met the diagnostic criteria for ENH. Maternal preeclampsia, the presence of labor, maternal treatment with MgSO 4 , Apgar scores, birth weight, gestational age and respiratory distress syndrome were significantly associated with ENH by univariate analysis. Only gestational age and maternal preeclampsia were significantly associated with ENH by multiple logistic regression. Conclusion:Gestational age and maternal preeclampsia were independent risk factors for ENH in our population of premature infants.

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Neonatal morbidity and mortality associated with maternal haemolysis elevated liver enzymes and low platelets syndrome

Abstract: : Before 32 weeks of gestation both respiratory and cardiovascular morbidity and intra-uterine growth retardation associated with HIP is further aggravated by a maternal HELLP syndrome.

Cited by 30 publications

References 8 publications

Early Postnatal Blood Pressure in Preterm Infants: Effects of Chorioamnionitis and Timing of Antenatal Steroids

Early Postnatal Blood Pressure in Preterm Infants: Effects of Chorioamnionitis and Timing of Antenatal Steroids

Neonatal Outcome in Pregnancies after Preterm Delivery for HELLP Syndrome

Early neonatal hypotension in premature infants born to preeclamptic mothers

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