HELLP syndrome: the spectrum of maternal and fetal complications

Abstract

Introduction. The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. Maternal mortality in patients diagnosed with this pathology varies between 2–24% and reaches up to 75%. Complications are severe and represent major medical emergencies. Purpose. Assessment of maternal and fetal complications of HELLP syndrome. Material and methods. A retrospective-prospective, descriptive study was performed that included 55 patients diagnosed with HELLP syndrome according to clinical and paraclinical criteria. The statistical data were processed in the statistical program SPSS 19 and Microsoft Excel. Results. The mean age of the patients included in the study was 28.26±5.77 years. One third of patients were at first birth 36.36% (20), the others being multiparous 63.64%(35). Maternal complications of HELLP syndrome are listed in table 1. DIC syndrome presented a broad clinical picture: nasal and gingival hemorrhages in 7 (13.46±4.73%), conjunctival blood suffusions in 5 (9.09±3.88%), petechiae and bruises in 33 (60.00±6.60%), thrombosis of the pulmonary vessels in 11 (20.00±5.93%) patients. Fetal complications of HELLP Syndrome were: intrauterine growth restriction 29.09%(16); stillbirth 7.27%(4); thrombocytopenia 10.9% (6), respiratory distress syndrome 3.63% (2); leukopenia 3.63% (2). Conclusions. Complications of HELLP syndrome represent major emergencies, which are manifested by the presence of dysfunction or insufficiency of multiple organs and systems, with a high rate of invalidation and death.