[Maternal morbidity and mortality in HELLP Syndrome]

To describe the maternal morbidity and mortality in pregnancies complicated by HELLP Syndrome.

This is a descriptive and prospective study of women with HELLP Syndrome managed at our center from January 1998 through March 2000. Patients are grouped into 3-class system of Mississippi classification.

170 cases were analysed, 156 (92%), ocurred ante partum and 14 (8%) postpartum; 15 cases (9%) developed at < 27 weeks, 112 (66%) between 28 to 36 weeks of gestational age and 43 (25%) at term. Maternal morbidity included acute renal failure (13.5%), abruptio placentae (6.6%), pneumonia (3%), subcapsular liver hematoma (2.3%), pulmonary edema (2.3%), diseminated intravascular coagulopathy (1.7%) and cerebral hemorrhage (1.2%). Maternal mortality was 4.7% (8 patients), 7 deaths ocurred in patients with class I disease and only one with class II HELLP Syndrome. 6 maternal deaths (75%) were associated to eclampsia. Up to 85% of the maternal morbidity and mortality developed with class I disease (platelet nadir < 50,000 mm3.

There is a progressive rise in maternal morbidity and mortality as the pregnancy moves from class III to class I HELLP Syndrome. 75% of maternal mortality was associated with eclampsia. Early diagnosis of this syndrome could improve maternal prognosis and outcome.