Maternal haemolysis, elevated liver enzymes and low platelets syndrome: specific problems in the newborn

To evaluate the effects of maternal haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome on the fetus and neonate we retrospectively investigated the outcome of 87 pregnancies. All women showed thrombocytopenia, elevated liver enzymes and haemolysis. None of them died. Nine infants were stillborn (9.9%). Of the 82 liveborn infants, 66 were delivered by caesarean section. Median gestational age of the liveborn infants was 32.6 weeks, mean birth weight was 1576 g +/- 699 g (mean +/- SD). Of these infants, 44% were small for gestational age. Perinatal asphyxia rate was 21.6%. Nine infants died in the 1st week after birth. Complications during admission included neonatal respiratory disease (43.2%), hyperbilirubinaemia (44.7%), persistent ductus arteriosus (16.2%), thrombocytopenia (34%) and hypoglycaemia (16.2%). Artificial ventilation was necessary in 37 infants. Mean duration of admission was 51 days. HELLP syndrome is associated with poor perinatal outcome; the incidence of caesarean section is high and there is an increased risk for preterm birth and growth retardation. No specific neonatal pathology due to maternal HELLP syndrome was found.