Perinatal Outcomes in Severe Preeclampsia-Eclampsia with and without HELLP Syndrome

Gül, Ahmet; Cebeci, Altan; Aslan, Halıl; Polat, İbrahim; Ozdemir, Aykut; Ceylan, Yavuz

doi:10.1159/000082648

Cited by 70 publications

(62 citation statements)

References 26 publications

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“…However, there are further studies showing that gestational age was more effective than maternal disease for perinatal outcomes (7,(17)(18)(19). In two studies, neonatal death rates were not different between HELLP syndrome and severe preeclampsia at the same stage of gestation (7,20). In our study, women were divided into two gestational age groups and perinatal outcomes were evaluated separately in these two groups.…”

Section: Discussionmentioning

confidence: 72%

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: 72%

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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“…These include: 1) Immediate delivery which is the primary choice at 34 weeks' gestation or later.2) Delivery within 48 hours after evaluation, stabilization of the maternal clinical condition and corticosteroid (CS)treatment. At 27 to 34 weeks of gestation, this option appears appropriate and rational for the majority of cases [21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

HELLP Syndrome-A life threatening complication of severe pre eclampsia

Bangal

Chandurkar

Sachdev

et al. 2013

Int J of Biomed & Adv Res

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HELLP Syndrome is a life threatening complication of severe pre eclampsia ,which is characterized by evidence of hemolysis, elevated liver enzymes and low platelet count during second half of pregnancy.If untreated , it carries high risk of maternal and perinatal morbidity and mortality due to hepatic and renal complications. A case of HELLP Syndrome with severe pre eclampsia in a primigravida at 39 weeks of pregnancy is reported. She was a known case of severe pre eclampsia and was taking treatment in a private nursing home.She was refered with a picture of HELLP Syndrome.Caesarean section under general anesthesia for fetal distress was carried out following single donar platelet transfusion. She had gross derrangement of hepatic and renal functions and thrombocytopenia following caesarean section. She was treated aggresively in intensive care unit with transfusion of whole blood ,fresh frozen plasma, multiple single donar platelet transfusions ,antihypertensive agents and broad spectrum antibiotics.Patient required multidisciplinary team approach for management.Patient was discharged after fifteen days from hospital.

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“…The perinatal mortality rate related to HELLP syndrome is between 7.4% and 34%. 18 Neonatal thrombocytopenia occurs in between 15%and 38% cases and is significant risk factor for both intraventricular hemorrhage and long term neurological complication. 18 In the present study neonatal mortality was seen in 17.64% babies with HELLP syndrome 25% with partial HELLP syndrome which is comparable to above studies.…”

mentioning

confidence: 99%

“…18 Neonatal thrombocytopenia occurs in between 15%and 38% cases and is significant risk factor for both intraventricular hemorrhage and long term neurological complication. 18 In the present study neonatal mortality was seen in 17.64% babies with HELLP syndrome 25% with partial HELLP syndrome which is comparable to above studies. When perinatal results were evaluated in Selahattin et al study, it was found that HELLP syndrome cases had six times more risk of neonatal mortality than severe preeclampsia cases even though it was statistically not significant.…”

mentioning

confidence: 99%

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A study of maternal and perinatal outcome in cases of HELLP and partial HELLP syndrome

Durugkar

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. The objective of the present prospective study is to study on incidence, diagnosis, and variable presentations of HELLP syndrome in preeclampsia to analyse the severity and complications, as it is associated with maternal, perinatal morbidity and mortality. HELLP syndrome is difficult to diagnose when it presents with atypical clinical features.Methods: In the prospective study of 300 admitted cases with more than 20 weeks of gestation, were having preeclampsia. The selected cases were analyzed clinically with relevant history, clinical data and detailed laboratory investigations made for better analyses of complications and outcome in HELLP syndrome.Results: Under further clinical diagnosis of 300 cases of preeclampsia, 34 cases (11.33%) were of HELLP Syndrome and 44 (14.66%) cases were of partial HELLP syndrome. The present study shows 2.9% maternal mortality in HELLP and 4.5% in partial HELLP syndrome. Perinatal mortality was 17.6% with HELLP and 25% with partial HELLP.Conclusions: The diagnosis of HELLP syndrome has been made as a severe variant and complication of severe preeclampsia and eclampsia. It needs early diagnosis, timely intervention to arrest further progress and complications like multi organ dysfunction, renal failure, DIC, abruption etc and to improve maternal and perinatal outcome.

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Perinatal Outcomes in Severe Preeclampsia-Eclampsia with and without HELLP Syndrome

Cited by 70 publications

References 26 publications

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

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

HELLP Syndrome-A life threatening complication of severe pre eclampsia

A study of maternal and perinatal outcome in cases of HELLP and partial HELLP syndrome

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