First-trimester HALP score as a predictor of placental abruption and adverse outcomes

This study evaluates the predictive value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score for abruption and its consequences.

This retrospective study included patients diagnosed with placental abruption. Clinical data, biochemistry, blood cell counts, HALP score, and neonatal outcome were recorded for the patients included in the study, measured in the first trimester. The HALP score was compared between patients with and without composite adverse outcomes (CAO) and between patients with and without intrauterine fetal death (IUFD). Logistic regression analysis was performed to determine the independent risk factors for placental abruption.

A total of 457 patients were included in the study, comprising 157 patients diagnosed with placental abruption and 300 controls. The HALP score was significantly lower in the abruption group compared to the control group. There were statistically significant differences between the two groups in neonatal outcomes. The HALP score was significantly lower in the IUFD group, the NICU group, and the CAO group. According to the receiver operating characteristic analysis, the optimal cut-off value of the HALP score was 3.2, with 70% sensitivity and 66% specificity for predicting abruption, 3.48 with 67% sensitivity and 52% specificity for predicting NICU admission, 3.1 with 68% sensitivity for predicting CAO, and 3.2 with 69% sensitivity for predicting IUFD. Multivariate regression analysis revealed that chronic diseases were associated with placental abruption 48 times and HALP score 2.1 times.

The HALP score was found to be significantly lower in patients diagnosed with placental abruption.