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Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
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A pitfall in analysis of proteins synthesized by sweat glands from patients with cystic fibrosis by two-dimensional gel electrophoresis and double-label autoradiography.

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Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
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The HELLP syndrome.

C A Kirkpatrick1

  • 1Service de Gynécologie-Obstétrique, Hôpital Erasme, Brussels, Belgium. christine.kirkpatrick@erasme.ulb.ac.be

Acta Clinica Belgica
|May 25, 2010
PubMed
Summary
This summary is machine-generated.

HELLP syndrome, a pregnancy complication involving hemolysis, elevated liver enzymes, and low platelets, requires prompt diagnosis and multidisciplinary care. Early delivery and close maternal surveillance are crucial for improving outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Hematology

Background:

  • HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) affects 0.5-0.9% of pregnancies.
  • It is a severe complication, often associated with preeclampsia.
  • The syndrome can manifest before or shortly after delivery.

Purpose of the Study:

  • To review the occurrence, diagnosis, complications, surveillance, treatment, delivery modes, and recurrence risks of HELLP syndrome.
  • To synthesize current knowledge on managing this serious obstetric complication.
  • To emphasize the importance of expert multidisciplinary care.

Main Methods:

  • Systematic review of clinical literature published between 2000 and 2009.
  • Searches conducted using PubMed and Cochrane databases.
  • Focus on occurrence, diagnosis, complications, surveillance, treatment, delivery, and recurrence.

Main Results:

  • HELLP syndrome occurs in 0.5-0.9% of pregnancies, and 10-20% of severe preeclampsia cases.
  • Approximately 70% of cases develop before delivery, with the remainder within 48 hours postpartum.
  • Delivery is indicated after 34 weeks gestation or with maternal/fetal deterioration; vaginal delivery is preferred.

Conclusions:

  • Prompt recognition and aggressive multidisciplinary management are essential for improving materno-fetal prognosis.
  • Close maternal surveillance post-delivery is critical.
  • Corticosteroids may aid fetal lung maturation but have uncertain maternal benefit in HELLP syndrome.