Perinatoloji Dergisi 2005; 1(1): 15-24

Online published date : 1 March 2005

The evaluation of cases with HELLP syndrome

 

Pınar Kumru, Özgür P. Kartal, Gültekin Köse, Nurettin Aka, Begüm Büyükoğlu

 

Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul

 

Objective: To evaluate the maternal-fetal mortality and morbidity results and relationship between perinatal and maternal complications and maternal laboratory parameters.

Methods: The laboratory findings, maternal- fetal mortality and morbidity results of 25 cases with HELLP syndrome hospitalised in our clinic between 1/1/1998 and 1/11/2004 were evaluated retrospectively. The relation between laboratory parameters and the risk of perinatal and maternal complications of women that had at least one perinatal and maternal complication were evaluated.

Results: Of the cases with HELLP syndrome 92% had preeclampsia. The mean age was 28.6 ± 5,6 years and 72% were multiparas. Mean age of gestation was 31.8 ± 4.8 weeks, mean newborn weight was 1580.9 ± 850.6 g. Of the 88% of the cases caeserian sections were performed. Serious changes were seen in the hematologic results, liver and renal function tests of cases with HELLP syndrome. Maternal mortality occured as a result of DIC in two cases. The most common cause of maternal morbidity was abruptio placenta (28%), the most common perinatal complication was found to be prematurity (76%). Prolongation of prothrombin time, lowered platelets, increased levels of AST, ALT, bilirubin and creatinine were found as laboratory parameters in the group with maternal complications. Decrease in fibrinogen levels was noted in the group with perinatal complications. No significant changes in laboratory parameters were found to predict perinatal complications in groups selected according to laboratory parameters except fibrinogen levels < 200 mg/dl and creatinine levels > 2 mg/ dl. However, platelet numbers < 70 000 mm3, AST levels < 200 mg/dl and creatinine levels > 2 mg/dl were found to be risk denominators for prediction of maternal complications separately.

Conclusion: HELLP syndrome seriously increases maternal-fetal mortality and morbidity. Laboratory parameters in cases with HELLP syndrome are not efficient in detecting perinatal results, but can be used as risk denominators in evaluating maternal complications.
 
Keywords

HELLP syndrome, Maternal-fetal mortality and morbidity.