M L Miranda1, A J Vallejo-Vaz1, L Cerrillo2, M L Marenco3, J Villar1, P Stiefel1. 1. Vascular Risk Unit, Service of Internal Medicine, IBIS, Hospital Universitario Virgen del Rocío, SAS, Universidad de Sevilla, CSIC, Avda. Manuel Siurot s/n, 41013 Seville, Spain. 2. Service of Obstetrics and Gynecology, Hospital Universitario Virgen del Rocío, SAS, Avda. Manuel Siurot s/n, 41013 Seville, Spain. 3. Service of Anaesthesia, Hospital Universitario Virgen del Rocío, SAS, Avda. Manuel Siurot s/n, 41013 Seville, Spain.
Abstract
OBJECTIVES: To analyze the frequency of the different clinical presentations of the disease in women with HELLP syndrome and the most important factors that can predict a different maternal and fetal outcome. STUDY DESIGN: This is a cross-sectional, consecutive, case-series study, the subjects being all patients with HELLP syndrome admitted to our Hospital within the last decade (1999-2009). RESULTS: The rate of maternal complications was 43.0% and perinatal mortality 14.1%. The severity of the syndrome, measured by The Mississippi Classification, influenced the rate of maternal complications but not fetal mortality: the rate of maternal complications among women in class 1 HELLP syndrome was 67.6%, compared to 49.3% in class 2 and 24.0% in class 3 HELLP syndrome, p<0.0001. In a 21.8% of women, the onset of the disease was after delivery. We highlight the fact that those cases with an early puerperium onset of the disease were those with a higher number of maternal complications (odds ratio: 2.38; CI: 1.05-5.44). CONCLUSIONS: These results suggest the possibility of an increased complication rate when the onset of the syndrome appears after delivery and the necessity of having a high grade of suspicion in every case to diagnose the disease, even when the gestation and delivery were normal.
OBJECTIVES: To analyze the frequency of the different clinical presentations of the disease in women with HELLP syndrome and the most important factors that can predict a different maternal and fetal outcome. STUDY DESIGN: This is a cross-sectional, consecutive, case-series study, the subjects being all patients with HELLP syndrome admitted to our Hospital within the last decade (1999-2009). RESULTS: The rate of maternal complications was 43.0% and perinatal mortality 14.1%. The severity of the syndrome, measured by The Mississippi Classification, influenced the rate of maternal complications but not fetal mortality: the rate of maternal complications among women in class 1 HELLP syndrome was 67.6%, compared to 49.3% in class 2 and 24.0% in class 3 HELLP syndrome, p<0.0001. In a 21.8% of women, the onset of the disease was after delivery. We highlight the fact that those cases with an early puerperium onset of the disease were those with a higher number of maternal complications (odds ratio: 2.38; CI: 1.05-5.44). CONCLUSIONS: These results suggest the possibility of an increased complication rate when the onset of the syndrome appears after delivery and the necessity of having a high grade of suspicion in every case to diagnose the disease, even when the gestation and delivery were normal.
Authors: Pablo Stiefel; María L Miranda; Hada Macher; Luis M Beltran-Romero; Rocio Muñoz-Hernandez Journal: Hypertens Res Date: 2017-03-23 Impact factor: 3.872