HELLP syndrome in Hospital Nacional Guillermo Almenara Irigoyen: Clinical presentation and complications of an obstetric emergency

Abstract

Introduction: HELLP syndrome is a multisystemic disease characterized by hemolysis, elevated liver enzymes and trombocitopenia1, considered as a complication of severe preeclampsia.

Objectives: o determine the characteristics of patients with HELLP syndrome in Hospital Nacional Guillermo Almenara Irigoyen between years 2005 and 2008.

Material and method: Retrospective analysis of 45 medical records from patients with HELLP syndrome.

Results: 71.1% (32/45) of patients were between 20 and 35 years old. Severe preeclampsia and previous abortion were the most frequent findings in past obstetric history (33.33% and 26.7%, respectively). The minimum hemoglobin value was 4.12 mg/dL, the minimum platelet count was 17,000 cell/mm3, and the maximul value for LDH was 8,050 U/L. Main maternal complications reported were acute respiratory distress syndrome (14, 31.11%) and acute renal failure (10, 22.2%). 26.7% of patients (12/45) were admitted to the Critical Care Unit and there was a significant difference between the number of patients admitted and the ones who were not, with respect to platelet counts below 50,000 (66.7% vs. 24.2%, p=0.009). 68.9% patients (31/45) were diagnosed during pregnancy, and 30 of them delivered their babies by a Cesarean section. The most frequent neonatal complication was pre-term birth (80.6%). There was a significant difference between mean maternal hemoglobin concentrations and a neonatal history for depression at birth (8.15 ± 1.63 vs. 10.53 ± 2.44, p=0.007).  

Conclusions: These findings show that HELLP syndrome causes high maternal and neonatal morbidity rates, and the outcome depends on an early diagnosis and timely therapy.