Maternal and neonatal outcome of pregnancies complicated with maternal HELLP syndrome

Preeclampsia complicated by the HELLP syndrome is associated with poor maternal outcome; there is scant information on neonatal outcome.

To evaluate the outcome of infants born to mothers with HELLP syndrome.

Chart review comparing perinatal variables and the clinical course of 23 infants born to mothers whose pregnancy was complicated with HELLP syndrome (H) with 23 infants of mothers with uncomplicated preeclampsia (P).

Infants in the H group, when compared with those in the P group, had a higher incidence of low Apgar scores (52% vs 18%, p < 0.01), lower admission systolic blood pressure (45 +/- 7 vs 32 +/- 11, p < 0.01), and more frequent need for assisted ventilation (61% vs 30%, p < 0.05). There were no differences between the two groups of infants in hematocrit, leukocyte and platelet count, or duration of ventilation and hospitalization.

These findings suggest that infants born to preeclamptic mothers who develop HELLP syndrome have an increased need for resuscitation at delivery and a higher incidence of postnatal cardiopulmonary instability. Thus mothers with HELLP syndrome should be identified promptly and delivered in level II or III centers with appropriate facilities for management of these newborn infants at risk for perinatal asphyxia and a potential for long-term neurologic sequelae.