Literature DB >> 11120513

HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: onset at < or =28.0 weeks' gestation.

B Haddad1, J R Barton, J C Livingston, R Chahine, B M Sibai.   

Abstract

OBJECTIVE: Our purpose was to determine whether the onset of the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome in women at < or =28.0 weeks' gestation is associated with an increased risk of adverse maternal and perinatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age. STUDY
DESIGN: Sixty-four patients with either the HELLP syndrome (n = 32) or severe preeclampsia but absent HELLP syndrome laboratory test results (n = 32), admitted at < or =28.0 weeks' gestation between July 1, 1992, and April 30, 1999, were studied. Maternal and perinatal outcomes were compared between the 2 groups. Statistical analysis was performed by the Student t test and the Fisher exact test.
RESULTS: There were no significant differences between the 2 groups regarding African-American race (59% vs 75%), nulliparity (50% vs 56%), or the use of corticosteroids (59% vs 78%). There were no maternal deaths. One woman with the HELLP syndrome had a liver hematoma. The rate at which transfusion of blood products was required was significantly greater in women with the HELLP syndrome than in those with severe preeclampsia only (25% vs 3%; P <.05). There were no significant differences between the 2 groups with respect to eclampsia (16% vs 13%), abruptio placentae (6% vs 9%), disseminated intravascular coagulopathy (13% vs 0%), pulmonary edema (13% vs 6%), acute renal failure (3% vs 0%), pleural effusion (3% vs 3%), or ascites (6% vs 16%). No significant differences were found between the 2 groups with respect to neonatal death (11% vs 17%), respiratory distress syndrome (78% vs 86%), or composite neonatal morbidity.
CONCLUSIONS: Except for the need for transfusion of blood products in women with the HELLP syndrome, onset at < or =28.0 weeks' gestation is not associated with an increased risk of adverse maternal or neonatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age.

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Year:  2000        PMID: 11120513     DOI: 10.1067/mob.2000.106975

Source DB:  PubMed          Journal:  Am J Obstet Gynecol        ISSN: 0002-9378            Impact factor:   8.661


  10 in total

1.  Maternal and fetal alternative complement pathway activation in early severe preeclampsia.

Authors:  M Camille Hoffman; Kristen K Rumer; Anita Kramer; Anne M Lynch; Virginia D Winn
Journal:  Am J Reprod Immunol       Date:  2013-10-16       Impact factor: 3.886

2.  Physiological changes of pregnancy and the Swansea criteria in diagnosing acute fatty liver of pregnancy.

Authors:  Adam Morton; Josephine Laurie
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3.  Comparison of maternal and neonatal outcomes in women with HELLP syndrome and women with severe preeclampsia without HELLP syndrome.

Authors:  Abdulkadir Turgut; Oya Demirci; Elif Demirci; Mehmet Uludoğan
Journal:  J Prenat Med       Date:  2010-07

4.  Severe Preeclampsia versus HELLP Syndrome: Maternal and Perinatal Outcomes at <34 and ≥34 Weeks' Gestation.

Authors:  Tuğba Kınay; Canan Küçük; Fulya Kayıkçıoğlu; Jale Karakaya
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Review 5.  Current best practice in the management of hypertensive disorders in pregnancy.

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6.  The Impact of Severe Maternal Morbidity on Perinatal Outcomes in High Income Countries: Systematic Review and Meta-Analysis.

Authors:  Tesfaye S Mengistu; Jessica M Turner; Christopher Flatley; Jane Fox; Sailesh Kumar
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7.  Temporizing management vs immediate delivery in early-onset severe preeclampsia between 28 and 34 weeks of gestation (TOTEM study): An open-label randomized controlled trial.

Authors:  Johannes J Duvekot; Ruben G Duijnhoven; Eva van Horen; Caroline J Bax; Kitty W Bloemenkamp; Ingrid A Brussé; Peter H Dijk; Maureen T Franssen; Arie Franx; Martijn A Oudijk; Martina M Porath; Hubertina C Scheepers; Aleid G van Wassenaer-Leemhuis; Joris van Drongelen; Ben W Mol; Wessel Ganzevoort
Journal:  Acta Obstet Gynecol Scand       Date:  2020-08-28       Impact factor: 3.636

Review 8.  Prognostic Factors of the Efficacy of High-dose Corticosteroid Therapy in Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome During Pregnancy: A Meta-analysis.

Authors:  Li Yang; Chenchen Ren; Minhong Mao; Shihong Cui
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Review 9.  Acute Kidney Injury in Pregnancy-specific Disorders.

Authors:  J Prakash; V C Ganiger
Journal:  Indian J Nephrol       Date:  2017 Jul-Aug

10.  Effect of HELLP syndrome on acute kidney injury in pregnancy and pregnancy outcomes: a systematic review and meta-analysis.

Authors:  Qiang Liu; Guan-Jun Ling; Shao-Quan Zhang; Wen-Qing Zhai; Yi-Juan Chen
Journal:  BMC Pregnancy Childbirth       Date:  2020-10-30       Impact factor: 3.007

  10 in total

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