[Pregnancy, labor and puerperium in patients with HELLP syndrome]

The aim of this study was to evaluate retrospectively 10 women with the syndrome of hemolysis, elevated liver enzymes, low platelets (HELLP)--age of patients, quality of antepartum medical care, clinical, biochemical parameters, treatment, course and duration of pregnancies, way of delivery, and puerperium.

Women in the study group were divided in order of platelets (PLT) levels: 4 patients with PLT levels lower than 50 G/l and 6 patients with PLT levels higher than 50 G/l. The mean duration of pregnancies in both groups was similar.

In the first group just one women delivered by vaginal route when compared with the cesarean delivery. We noticed lower frequency of antepartum medical visits among the first group. Such signs as vomiting, nausea, abdominal pain, pruritus occurred more frequently in the second group. The most common complication observed in both groups of patients was severe preeclampsia. HELLP syndrome was also observed in the multiple pregnancies. In the study group high blood concentrations of urea, creatinine, total bilirubin, alanine transaminase and aspartate aminotransferase were present. Termination of pregnancy is still recognised to be the best way of HELLP treatment, however the efficacy of steroid drugs administration as conservative treatment were also demonstrated.

The disseminated intravascular coagulation as the HELLP complication in the puerperium period seems to be a serious problem, which can conduct to the need of hysterectomy.