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[HELLP Syndrome: clinical-analytical characteristics and evolution observed in two years of experience]

A M Ghelfi1, F Garavelli1, F A Passarino2

  • 1Servicio de Clínica Médica, Hospital Escuela Eva Perón, Santa Fe, Argentina.

Hipertension Y Riesgo Vascular
|June 14, 2020
PubMed

Insights

HELLP syndrome, a severe form of preeclampsia, often presents variably, predominantly in gestational hypertension cases. While maternal complications were common, this study found no maternal deaths.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Critical Care Medicine

Background:

  • HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of preeclampsia.
  • The syndrome exhibits diverse clinical presentations, including complete/incomplete forms, varying severity classes, and antepartum/postpartum onset.
  • Understanding HELLP syndrome's characteristics is crucial for managing hypertensive disorders in pregnancy.

Purpose of the Study:

  • To describe and analyze the characteristics and clinical evolution of HELLP syndrome in hypertensive pregnant patients.
  • To identify common presentations and complications associated with HELLP syndrome.
  • To evaluate maternal outcomes in a cohort of patients with HELLP syndrome.

Main Methods:

  • Retrospective cohort study over two years.
  • Inclusion of hypertensive pregnant women diagnosed with HELLP syndrome during hospitalization.
  • Analysis of demographic data, clinical characteristics, syndrome classification, and maternal outcomes.

Main Results:

  • The study included 318 hypertensive pregnant women, with 28 diagnosed with HELLP syndrome.
  • The average maternal age was 25.8 years, and gestational age at diagnosis was 31 weeks.
  • HELLP syndrome was predominantly gestational (24/28), antepartum (25/28), and early onset (18/25), with incomplete forms and Class II thrombocytopenia being most frequent. 17 patients required intensive care, and 10 developed complications, but no maternal deaths occurred.

Conclusions:

  • HELLP syndrome presentation is variable, frequently observed in gestational hypertension, antepartum, and early onset.
  • Incomplete forms and Class II thrombocytopenia are more common presentations.
  • Despite frequent maternal complications, HELLP syndrome management in this cohort resulted in no maternal mortality.
Abstract

Keywords:
ArgentinaComplicaciones del embarazoGestational hypertensionHELLP syndromeHipertensión en la embarazadaPreeclampsiaPregnancy complicationsSíndrome HELLP

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