HELLP Syndrome: a hundred case descriptions in Bogotá-Colombia, 1999
DOI:
https://doi.org/10.18597/rcog.698Keywords:
HELLP, hypertensive pregnancy disorders, eclampsia, preeclampsia, severe preeclampsia, mortality maternalAbstract
OBJECTIVE: Establish the incidence of HELLP syndrome, describe its clinical and laboratory characteristics and the maternal and fetal morbidity and mortality.
MATERIAL AND METHODS: A descriptive prospective study of the hundred preeclamptic patients with HELLP that were admitted at high risk obstetric unit San Pedro Claver Hospital, Bogotá from October 1998 to July 1999.
OUTCOME: There was an incidence of 9.6 events/ 1000 live births, the average age of those with HELLP syndrome was 29.68% of the HELLP cases were parous women.
Maternal complications: renal failure 15%, eclampsia 15%, 12% required treatment in intensive care. Maternal mortality was 6% and perinatal mortality 9%.
The count of platelet lower to 50.000 mm and high level of transaminases has been associated with increase risk of maternal mortality
CONCLUSION: HELLP Syndrome exhibits high maternal and fetal morbidity and mortality rates. Medical staff must be able recognize these characteristics symptoms and be aware of the possibility of HELLP syndrome being the cause.
Author Biographies
Fernando Martínez Martínez
Sandra Patricia Zapata Clavijo
Sandra Liliana Quintero
References
Pritchard JA, Weisman R, Ratnoff OD, et al. Intravascular hemolysis, thrombocitopenia and other hematologic abnormalities associated with severe toxemia of pregnancy. N Engl. J Med; 1954; 250: 89.
Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: A severe consequence of hypertension in pregnancy. Am. J. Obstet. Gynecol; 1982; 142:159.
Sibai B. The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) Much ado about nothing? Am. J. Obstet Gynecol; 1990; 162: 311-6.
Martin JN, Blake PG, Perry KG, et al. The natural history of HELLP syndrome: Patterns of disease progression and regression. Am. J. Obstet. Gynecol; 1991; 164:1500-13.
Sibai B, Taslimi M, EL-Nazer A., et al. Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia. Am. J. Obstet Gynecol; 1986; 155: 501-9.
Sibai B, Ramadan M, Usta I, Salama M, Mercer B, Friedman S. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets. (HELLP Syndrome). Am J Obstet Gynecol; 1993; 169: 1000-6.
National High Blood Pressure Education Program Working Group: Report on high blood pressure in pregnancy. Am J Obstet Gynecol; 1990;163:1689-1712.
Helguera M, Marañón R, Vigil de Gracia y Cols. Síndrome HELLP análisis de 102 casos. Ginec Obstet Mex; 1996; 64: 528-533.
Rojas G, Viveros E, Fernández E, Esparza J, Cabra R, Kably A. Síndrome HELLP Consecuencia severa de enfermedad hipertensiva inducida por el embarazo. Ginec Obst Mex; 1996; 64: 523-527.
Martin JN, Rinehart BK, May WL. The spectrum of severe preeclampsia: Comparative analysis by HELLP (hemolysis, elevated liver enzyme levels, and low platelet count) syndrome classification. Am J Obstet Gynecol;1999; 180:1373-84.
Rath W, Faridi A., Dudenhausen JW. HELLP syndrome. J Perinat Med; 2000;28:249-60.
Martin J, Blacke P, Perry K, McCaul J, Hess W and Martin R. The natural history of HELLP syndrome: Patterns of disease progression and regression. Am J Obstet Gynecol; 1991; 164: 1500-13.
Vigil P, Tenorio R, Cejudo E, Helguera A, García E. Diferencias entre preeclampsia, síndrome HELLP y eclampsia, evaluación materna. Ginec Obst Mex; 1996; 64: 377.
Argueta M, Neri C, Lira J, Ibarguengoitia F, Vázquez E. Síndrome HELLP, siete años de experiencia en el instituto Nacional de Perinatología. Ginec Obst Mex; 1995; 63: 217-221.
Vigil-De Gracia P. Pregnancy complicated by pre-eclampsia with HELLP syndrome. Int J Gynecol Obstet; 2001 Jan; 72: 17-23.
Martin JN, May WL, Magann EF, et al. Early risk assessment of severe pre-eclampsia: Admission battery of symptoms and laboratory tests to predict likelihood of subsequent significant maternal morbidity. Am J Obstet Gynecol; 1999; 180: 1407-14.
Isler CM, Rinehart BK, Terrone DA, Martin RW, Magann EF, Martin Jr JN. Maternal mortality associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynecol; 1999; 81: 924-8.
Visser W, Van Pampus MG, Treffers P, Wallenburg H. Perinatal results of hemodynamic and conservative temporizing treatment in severe pre-eclampsia. Eur.J.Obstet.Gynecol.Reprod. Biol; 1994; 53: 175 - 181.
Visser W, Wallenburg H. Temporizing management of severe pre-eclampsia with and without the HELLP syndrome. Br J Obstet Gynecol; 1995; 102: 111-7.
Van Pampus MG, Wolf H, Westenberg S, Van der Post J, Bonsel G, Treffers P. Maternal and perinatal outcome after expectant management of the HELLP syndrome compared with pre-eclampsia without HELLP syndrome. Eur J Obstet Gynecol.Reprod.Biol; 1998; 76: 31-36.
Audibert F, Friedman S, Frangieh A, Sibai B. Clinical utility of diagnostic criteria for the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynecol; 1996; 175: 460-4.
Magaan EF, Bas D, Chauhan SP, et al. Antepartum Corticosteroids: Disease stabilization in patients with the syndrome of hemolysis, elevated liver enzimes, and low platelets (HELLP). Am J Obstet Gynecol; 1994; 171: 1148-1153.
Magaan EF, Perry KG, Meydrech EF, et al. Postpartum corticosteroids. Accelerated recovery from the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) Am J Obstet Gynecol; 1994;171: 1154-1158.
Vigil-De Gracia P, García-Cáceres E. Dexametasone in the postpartum treatment of HELLP syndrome. Int J Gynecol Obstet; 1997; 59: 217-221.
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