ADVERSE FETOMATERNAL OUTCOMES IN WOMEN WITH HELLP SYNDROME
Main Article Content
Keywords
Pregnancy, HELLP, syndrome, Adverse fetomaternal outcomes
Abstract
Background: HELLP syndrome complicates 0.5 to 0.9% of all pregnancies and 10-20 % cases of severe preeclampsia. Maternal mortality in women with HELLP syndrome has been reported as 1 to 25%. 70% of cases of HELLP syndrome occur antenatally with highest incidence between 27th – 37th weeks of gestation while 10 % occurs before 27th week and 20 % after 37th week of gestation.
Objective: To determine the different adverse fetomaternal outcomes in women with HELLP syndrome.
Material and Methods: This descriptive study was conducted in the Gynae & Obstetrics Unit at LRH MTI Peshawar in collaboration with technical help of Karachi Metropolitan University from 10th October 2020 to 30th April 2021. A total of 114 antenatal women in reproductive age group of any parity with HELLP syndrome were included in the study. Adverse maternal outcomes were analyzed in terms of: DIC, acute renal failure, placental abruption, eclampsia, blood or blood products transfusion, pulmonary edema and maternal death. Adverse fetal outcomes were analyzed in terms of intrauterine fetal demise, preterm delivery, NICU admission and early neonatal death.
Results: Adverse fetomaternal outcomes were disseminated intravascular coagulation 17.5%, acute renal failure 28.1%, placental abruption 12.3%, eclampsia 14%, blood products transfusion 61.4%, pulmonary edema 11.4%, maternal death 7%, intrauterine fetal demise 25.4%, preterm delivery 24.6%, NICU admission 33.3% and neonatal death was 7.9%.
Conclusion: The result of present study shows that HELLP syndrome considerably affects the maternal and perinatal outcome in pregnancy.
References
2. Dusse LM, Alpoim PN, Silva JT, Rios DRA, Brandão AH, Cabral ACV. Revisiting HELLP syndrome. Clin Chim Acta. 2015 Dec;451:117–20.
3. Wallace K, Harris S, Addison A, Bean C. HELLP Syndrome: Pathophysiology and Current Therapies. Curr Pharm Biotechnol. 2018 Nov 27;19(10):816–26.
4. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: Clinical issues and management. A Review. BMC Pregnancy Childbirth. 2009 Dec;9(1):8.
5. Geary M. The HELLP syndrome. BJOG An Int J Obstet Gynaecol. 1997 Aug;104(8):887–91.
6. Erkılınç S, Eyi EGY. Factors contributing to adverse maternal outcomes in patients with HELLP syndrome. J Matern Neonatal Med. 2018 Nov;31(21):2870–6.
7. Bang N, Satia M, Poonia S. Obstetric and neonatal outcome in pregnancies complicated by hemolysis elevated liver enzymes low platelet count syndrome at a tertiary care centre in India. Int J Reprod Contraception, Obstet Gynecol. 2016;2407–12.
8. Kota LN, Garikapati K, Kodey PD, K. B. G. Study on HELLP syndrome - maternal and perinatal outcome. Int J Reprod Contraception, Obstet Gynecol. 2017 Jan;6(2):714.
9. Rimaitis K, Grauslyte L, Zavackiene A, Baliuliene V, Nadisauskiene R, Macas A. Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre. Int J Environ Res Public Health. 2019 Jan 3;16(1).
10. Miranda ML, Vallejo-Vaz AJ, Cerrillo L, Marenco ML, Villar J, Stiefel P. The HELLP syndrome (hemolysis, elevated liver enzymes and low platelets): Clinical characteristics and maternal–fetal outcome in 172 patients. Pregnancy Hypertens An Int J Women’s Cardiovasc Heal. 2011 Apr;1(2):164–9.
11. Lisonkova S, Razaz N, Sabr Y, Muraca G, Boutin A, Mayer C, et al. Maternal risk factors and adverse birth outcomes associated with HELLP syndrome: a population‐based study. BJOG An Int J Obstet Gynaecol. 2020 Sep 13;127(10):1189–98.
12. Kaur AP, Kaur N, Dhillon SPS. HELLP syndrome and its implications on maternal and perinatal outcome. Int J Reprod Contraception, Obstet Gynecol. 2018 Feb 27;7(3):1007.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Sabaeena Wali
FCPS (Obstetrics & Gynaecology), Consultant Gynaecologist and Obstetrician, DHQ Hospital Nowshera Pakistan
Dr. Khansa Fazil Qazi
FCPS (Obstetrics & Gynaecology), Consultant Gynaecologist and Obstetrician, DHQ Hospital, Nowshera Pakistan
Dr. Amna Begum
MBBS, FCPS, MCPS, Assistant Professor, Department of Obstetrics and Gynecology, Karachi Medical & Dental College /Abbasi Shaheed Hospital, Karachi Pakistan
Dr. Jamal Ara
FCPS (Medicine), Assistant Professor, Department of Medicine, Karachi Medical and Dental College, Karachi Pakistan
Dr. Rekha
FCPS (Obstetrics & Gynaecology), Senior Women Medical Officer, Liaquat University Hospital, Hyderabad Pakistan
Dr. Naeema Bibi
FCPS (Obstetrics & Gynaecology), Consultant Gynaecologist and Obstetrician, DHQ Hospital, Nowshera Pakistan