Clinical and biophysical aspects of HELLP-syndrome
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A.K. Ertan
Abstract
Objective: The maternal-perinatal outcome and the significance of biophysical parameters in HELPP syndrome patients were evaluated. Methods: Sixty cases of HELLP syndrome were determined by retrospective analysis. Medical history, correlation of clinical, laboratory findings, records of fetomaternal Doppler studies, Nonstress test and maternal-perinatal outcome data were evaluated. Chi-square test was used for statistical analysis, and p < 0.05 was accepted as the significance level. Results: The incidence of HELLP syndrome in our institution was 1.03%. Mean gestational age at birth was 33.2 weeks, mean birth weight was 1861 ± 710 g and mean umbilical pH was 7.25 ± 0.13. Neonatal thrombocytopenia was demonstrable in 38% of neonates. Patients with low antepartal platelets (< 60 000/μl) had a significantly higher incidence of intrauterine growth retarded fetuses than patients with higher platelet counts (p = 0,002). Doppler flow measurements were performed in 33 patients (55%). In 16 (48.4%) a pathological Doppler flow was documented. Doppler findings demonstrated very high sensitivity (83%) and specificity (80%) in predicting adverse outcome in growth retarded fetuses. In 17 patients (27%) fetal heart rate monitoring had an obvious pathologic pattern. Respiratory distress syndrome (74.4%) was the main indication for NICU admission. Perinatal mortality rate was 8.3% and neonatal mortality rate was 11.6%. Maternal morbidity rate was 30%. The most commonly observed maternal complications were abruptio placentae (n = 8), disseminated intravascular coagulation (n = 3) and severe postpartal bleeding (n = 3). Conclusions: In HELLP syndrome patients it is very important to closely follow maternal vital signs and fluid intake and output, and to perform fetal status assessment tests.Of the biophysical parameters,Doppler flow measurement is an especially helpful predictor of poor perinatal outcome in growth retarded fetuses in HELLP patients. Patients with very low platelets have a significantly higher risk of intrauterine growth retarded fetuses.
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Preterm premature rupture of the membranes and antioxidants: the free radical connection
- Vaginal lactobacilli and preterm birth
- Socioeconomic and environmental risk factors of bacterial vaginosis in early pregnancy
- Evaluation of creatine kinase level during long-term tocolysis
- Maternal serum glycodelin in premature rupture of membranes
- Clinical and biophysical aspects of HELLP-syndrome
- Blood flow velocity waveforms of the fetal middle cerebral artery in a normal population: reference values from 18 weeks to 42 weeks of gestation
- Cerebral hemoglobin concentration and oxygen saturation measured by intensity modulated optical spectroscopy in the human fetus during labor
- Growth discordance and the effect of a male twin on birth weight of its female co-twin: a population-based study
- Rhabdomyolysis during prolonged intravenous tocolytic therapy
- A rare presentation of Pompe disease with massive hypertrophic cardiomyopathy at birth
- Complete spontaneous resolution of severe nonimmunological hydrops fetalis with unknown etiology in the second trimester – a case report
- Epiphyseal separation of the distal humerus
- Congress Calendar
Articles in the same Issue
- Author Index
- Subject Index
- Contents
- Preterm premature rupture of the membranes and antioxidants: the free radical connection
- Vaginal lactobacilli and preterm birth
- Socioeconomic and environmental risk factors of bacterial vaginosis in early pregnancy
- Evaluation of creatine kinase level during long-term tocolysis
- Maternal serum glycodelin in premature rupture of membranes
- Clinical and biophysical aspects of HELLP-syndrome
- Blood flow velocity waveforms of the fetal middle cerebral artery in a normal population: reference values from 18 weeks to 42 weeks of gestation
- Cerebral hemoglobin concentration and oxygen saturation measured by intensity modulated optical spectroscopy in the human fetus during labor
- Growth discordance and the effect of a male twin on birth weight of its female co-twin: a population-based study
- Rhabdomyolysis during prolonged intravenous tocolytic therapy
- A rare presentation of Pompe disease with massive hypertrophic cardiomyopathy at birth
- Complete spontaneous resolution of severe nonimmunological hydrops fetalis with unknown etiology in the second trimester – a case report
- Epiphyseal separation of the distal humerus
- Congress Calendar
