PP166. HELLP syndrome: Challenges for establishing diagnostic criteria

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Pathology

Background:

• Preeclampsia is a significant public health concern during pregnancy.
• HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a severe variant of hypertensive disorders in pregnancy.
• The clinical presentation of hypertensive diseases in pregnancy is diverse, including pre-eclampsia and eclampsia.

Purpose of the Study:

• To critically assess the diagnostic criteria for HELLP syndrome as reported in the medical literature.
• To identify inconsistencies and gaps in the current diagnostic approaches for HELLP syndrome.

Main Methods:

• A comprehensive literature review was conducted using the Virtual Health Library.
• Keywords "HELLP syndrome" and "diagnosis" were employed, yielding 674 initial citations.
• After rigorous exclusion criteria, 16 original research articles were included for analysis.

Main Results:

• Significant variability exists in the clinical and laboratory markers used for HELLP syndrome diagnosis, with differing cut-off levels.
• Eclampsia, upper abdominal pain, nausea, and proteinuria were more frequent in HELLP syndrome patients.
• Elevated lactic dehydrogenase, AST, and uric acid levels correlated with poorer prognosis, yet no consensus exists for key diagnostic parameters.

Conclusions:

• Establishing standardized diagnostic criteria for HELLP syndrome remains a challenge.
• There is a need for large-scale studies to identify key signs, symptoms, and reliable diagnostic markers.
• Consensus on diagnostic indices is crucial for accurate and consistent identification of HELLP syndrome.