Korean J Obstet Gynecol.  2004 Mar;47(3):523-530.

Relationship between the Maternal-Fetal Complications and the Severity of HELLP Syndrome, Classified based on Maternal Platelet Count Nadir

Affiliations
  • 1Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.

Abstract


OBJECTIVE
To determine the incidence of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and assess the relationship between the maternal-fetal complications and the severity of HELLP syndrome, classified based on platelet count nadir.
METHODS
We reviewed the maternal and neonatal charts of ten pregnancies complicated by HELLP syndrome, managed at Dankook University Hospital between January, 1995 and December, 2002. Women were divided into 2 groups as class I HELLP which had a maternal platelet nadir 50,000 and 100,000/mm3. We compared the maternal and fetal complications between class I and class II HELLP syndrome. But we did not analyze statistically due to small number of patients.
RESULTS
There were four cases of class I HELLP and six cases of class II HELLP syndrome. The incidence of HELLP syndrome was 0.10% (10/10,238) in total deliveries and was 2.26% (10/443) in women with severe pre-eclampsia or eclampsia. The mean level of platelet counts nadir was 41,500/mm3 in class I and 64,000/mm3 in class II HELLP. The mean platelet recovery days (more than 100,000/mm3) were 6.0 and 4.2 days in each class. The mean values of the maximal aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) and uric acid might show no differences, but there might be difference in lactate dehydrogenase (LDH) levels which were 5854 and 1388 IU/L in each class. All patients with class I HELLP syndrome showed maternal complications, but only one patient with class II HELLP showed maternal complications. There might be no differences in the mean gestational ages and birth weights. The neonatal complications were similar in each class.
CONCLUSION
Our data suggest that patients with class I HELLP syndrome may be at increased risk for serious maternal complications, but the neonatal complications may be associated with gestational ages.

Keyword

HELLP syndrome

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
Birth Weight
Blood Platelets*
Eclampsia
Female
Gestational Age
HELLP Syndrome*
Humans
Incidence
L-Lactate Dehydrogenase
Liver
Platelet Count*
Pre-Eclampsia
Pregnancy
Uric Acid
Alanine Transaminase
Aspartate Aminotransferases
L-Lactate Dehydrogenase
Uric Acid
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