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[Management of the HELLP syndrome]
G Beucher1, T Simonet, M Dreyfus
1Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Caen, avenue Clemenceau, 14033 Caen cedex, France. beucher-g@chu-caen.fr
Gynecologie, Obstetrique & Fertilite
|November 15, 2008
Summary
Hemolysis, Elevated Liver enzyme, Low Platelets (HELLP) syndrome complicates preeclampsia, increasing maternal and fetal risks. Early diagnosis and prompt management, including timely delivery, are crucial for improved outcomes.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Hepatology
Context:
- HELLP syndrome is a severe condition associated with preeclampsia.
- It presents with hemolysis, elevated liver enzymes, and low platelets.
- Diagnosis can be challenging due to non-specific symptoms.
Purpose:
- To define the diagnostic criteria for HELLP syndrome.
- To outline the complications and prognosis associated with HELLP syndrome.
- To describe the management strategies for HELLP syndrome.
Summary:
- Biological markers include schistocytes, elevated bilirubin/LDH, increased transaminases, and thrombocytopenia.
- Maternal morbidity is significantly higher than in isolated preeclampsia, with risks including eclampsia and organ damage.
- Management involves intensive care and timely pregnancy termination, with expectant management potentially considered before 32 weeks.
Impact:
- Highlights the critical need for prompt diagnosis and management in severe obstetric emergencies.
- Emphasizes the importance of specialized care in Level 3 hospitals for maternal and neonatal outcomes.
- Provides insights into the prognostic significance of evolving biological parameters and recurrence rates.
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