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[The HELLP syndrome. 13 cases]
B Yannoulopoulos1, O Pourrat, J B de Meeus
1Clinique Gynécologique et Obstétricale, Hôpital Jean-Bernard, Poitiers.
Insights
HELLP syndrome, a pregnancy complication involving hemolysis, elevated liver enzymes, and low platelets, requires prompt delivery for favorable maternal outcomes. While prognosis is generally good, vigilance post-delivery is crucial.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Critical Care Medicine
Context:
- HELLP syndrome is a severe obstetric complication characterized by hemolysis, elevated liver enzymes, and low platelet count.
- It represents a significant cause of maternal and fetal morbidity.
- Understanding its presentation and management is critical for improved patient outcomes.
Purpose:
- To retrospectively analyze 12 cases of HELLP syndrome managed at the University Hospital Centre of Poitiers between 1982 and 1990.
- To discuss the causes, clinical progression, prognosis, and management strategies for HELLP syndrome.
- To evaluate the effectiveness of interventions and identify factors influencing maternal and fetal outcomes.
Summary:
- The study reviewed 12 HELLP syndrome cases, noting prophylactic Cesarean sections in six and eclamptic fits in two.
- No maternal deaths occurred, but adverse fetal outcomes included intrauterine growth retardation (7 cases), intrauterine fetal death (2 cases), and early neonatal death (1 case).
- While maternal parameters improved post-delivery, the syndrome could persist or worsen, highlighting delivery as the primary treatment.
Impact:
- This study underscores the critical role of timely delivery in managing HELLP syndrome, leading to favorable maternal prognoses.
- It emphasizes that while the condition typically resolves post-delivery, continued monitoring is necessary.
- The findings suggest a generally good long-term prognosis for future pregnancies with a low recurrence rate.
Abstract:
The Hellp syndrome is a complication of raised blood pressure in pregnancy, haemolysis, a rise in liver enzymes and thrombopenia. In this retrospective study we report 12 cases of Hellp syndrome which occurred in the University Hospital Centre of Poitiers between 1982 and 1990 and we discuss causes, the progress, the prognosis and the management. Six patients were helped by prophylactic Caesarean operation. Two patients had eclamptic fits. Fortunately there was no maternal death. There were seven cases of intrauterine growth retardation, two of in utero fetal death and one of early neonatal death. When clinical and biological parameters of the Hellp syndrome come right following delivery, the outlook for the mother is quickly favourable, but the syndrome can continue and sometimes become worse after delivery. Stopping the pregnancy is the basic treatment and conservative treatment has only a very limited success. Finally, the prognosis for the future is usually good and it is unlikely to recur.