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[HELP syndrome and anesthetic management]
K Kinouchi1, K Fukumitsu, K Yanagi
1Department of Anesthesiology, Osaka Medical Center, Japan.
Masui. the Japanese Journal of Anesthesiology
|May 1, 1996
Summary
HELLP syndrome, a serious pregnancy complication, affected 24 women between 1990-1994. While no maternal deaths occurred, significant morbidity and perinatal complications were observed, highlighting the need for careful management.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Critical Care in Pregnancy
Context:
- HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) is a severe variant of preeclampsia.
- This retrospective study analyzes cases from a single institution over a five-year period.
- Understanding the incidence and outcomes of HELLP syndrome is crucial for obstetric care.
Purpose:
- To report the incidence and clinical characteristics of HELLP syndrome in parturients.
- To describe maternal morbidity and perinatal outcomes associated with HELLP syndrome.
- To provide recommendations for anesthetic management in patients with HELLP syndrome.
Summary:
- A total of 24 cases of HELLP syndrome were identified among 8,224 deliveries (0.29% incidence).
- Maternal complications included eclampsia, renal failure, hydrothorax, and disseminated intravascular coagulation (DIC).
- Perinatal outcomes showed 3 intrauterine fetal deaths and 2 neonatal deaths, resulting in a 0.9% perinatal mortality rate.
Impact:
- The findings underscore the significant maternal and fetal risks associated with HELLP syndrome.
- Recommendations for anesthesia emphasize avoiding spinal/epidural anesthesia in bleeding-tendency cases and controlling hypertension during general anesthesia.
- This data contributes to the understanding of HELLP syndrome management and associated risks in obstetric practice.