HELLP syndrome: About 17 cases and literature review

##plugins.themes.academic_pro.article.sidebar##

Published Jun 22, 2010
Download
pdf
Vol. 88 No. 7 (2010): Issue Jul 2010

##plugins.themes.academic_pro.article.main##

Khaled Boudhraa
Mohamed Amine Jellouli
Mohamed Faouzi Gara

Abstract

Background : HELLP syndrome is defined as an association of hemolytic anemia, raised liver enzymes and thrombocytopenia. It is a severe manifestation of pre-eclampsia.
Aim : We tried to specify the epidemic factors and the best management of HELLP syndrome
Methods: A retrospective study held during 6 years in the department of gynaecology and obstetrics in La Marsa hospital and according to a literature revue.
Results: The dominating symptoms included low abdominal pain and vomiting. The syndrome was discovered after 30.5 weeks of amenorrhea on average. Infant extraction was by cesarean section in 11 cases. Maternal morbidity was mainly marked by eclampsia and haemostatic disturbances while neonatal morbidity was attributable to the included prematurity.
Conclusion: The main management consists essentially in a medical reanimation, in addition to a rapid foetal extraction.

Keywords:

Preeclampsia, HELLP, Maternal morbidity and mortality

##plugins.themes.academic_pro.article.details##

References

  1. Dorel A, Steven A. Friedman, Brian M. Mercer, F Audibert, Lu Kao, Baha M. Sibai. Neonatal outcome in severe preeclampsia at 24 to 36 weeks' gestation: Does the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome matter? Am J Obstet Gynecol 1999;180: 221-225
  2. F Audibert, Steven A. Friedman, Antoine Y. Frangieh, Baha M. Sibai. Clinical utility of strict diagnostic criteria for the HELLP (hemolysis, elevated liver enzymes, and low platelets syndrome. Am J Obstet Gynecol 1996;175:460-464
  3. Mark C. Chames, Bassam Haddad, John R. Barton, Jeffrey C. Livingston, Baha M. Sibai Subsequent pregnancy outcome in women with a history of HELLP syndrome at ² 28 weeks of gestation., Am J Obstet Gynecol 2003;188:1504-1508
  4. Els Th.M. Dams, Marloes H. M. de Vleeschouwer, Pieter W. J. van Dongen. Acute HELLP postpartum with renal failure.Euro J Obstet Gynecol Reprod Biol 1995;62:127-130
  5. Philippe Deruelle, Elodie Coudoux, Anne Ego, Véronique Houfflin-Debarge, Xavier Codaccioni, Damien Subtil.Risk factors for post-partum complications occurring after preeclampsia and HELLP syndrome: A study in 453 consecutive pregnancies, Euro J Obstet Gynecol Reprod Biol 2006;125:59-65
  6. Michel Dreyfus, Isabelle Tissier, Marie-Agathe Ndocko, Isabelle Denoual, Jean-Jacques Baldauf, Jean Ritter. Corticosteroid therapy for conservative management in marginally-viable pregnancy complicated by HELLP syndrome. Euro J Obstet Gynecol Reprod Biol 1999;85:233-234
  7. C. Hughes. Morbidité maternelle et néonatale du HELLP syndrome: À propos de 100 cas à Port-Royal. La Revue de la Sage-Femme 2004;3 :9-16
  8. Kottarathil A. Abraham, Mairead Kennelly, Anthony M. Dorman, J. Joseph Walshe Pathogenesis of acute renal failure associated with the HELLP syndrome: a case report and review of the literature. Euro J Obstet Gynecol Reprod Biol 2003;108:99-102
  9. Everett F. Magann, Joseph F. Washburne, Christopher A. Sullivan, Suneet P. Chauhan, John C. Morrison, James N. Martin Jr. Corticosteroid-induced arrest of HELLP syndrome progression in a marginally-viable pregnancy, Euro J Obstet Gynecol Reprod Biol 1995, ;59:217-219
  10. Karl S. Oláh, Christopher W. G. Redman, Harry Gee. Management of severe, early pre-eclampsia: is conservative management justified? Euro J Obstet Gynecol Reprod Biol 1993;51: 175-180
  11. K.G. Perry Jr., R.W. Martin, E.F. Magann, P.G. Blake, L. Robinette, J.N. Martin Jr. Expanded implementation of dexamethasone for hellp syndrome pregnancies improves maternal-perinatal outcomes., Am J Obstet Gynecol 1997;176: 108
  12. Carl J. Saphier, John T. Repke. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a review of diagnosis and management. Seminars in perinatology, Am J Obstet Gynecol 1998 ; 22: 118-133
  13. B. M. Sibai, Mohammed K. Ramadan, Radha S. Chri, Steven A. Friedman. Pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): Subsequent pregnancy outcome and long-term prognosis., Am J Obstet Gynecol 1995;172:125-129
  14. Tina R. Tomsen. HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) presenting as generalized malaise., Am J Obstet Gynecol 1995;172:1876-1880
  15. Andrea L. Tranquilli, Beatrice Landi, Alessandra Corradetti, Stefano Raffaele Giannubilo, Davide Sartini, Valentina Pozzi, Monica Emanuelli. Inflammatory cytokines patterns in the placenta of pregnancies complicated by HELLP syndrome. Am J Obstet Gynecol 2006;80:161
  16. V. Tsatsaris, B. Carbonne, M. Dupré La Tour, D. Cabrol, J. Milliez Is conservative treatment of HELLP syndrome safe?, Euro J Obstet Gynecol Reprod Biol 1998;80:139-141
  17. Maria G. Van Pampus, Hans Wolf, Steven M. Westenberg, Joris A. M. van der Post, Gouke J. Bonsel, Pieter E. Treffers. Maternal and perinatal outcome after expectant management of the HELLP syndrome compared with pre-eclampsia without HELLP syndrome. Euro J Obstet Gynecol Reprod Biol 1998;76:31-36
  18. P. Vigil-De Gracia, S. Silva, C. Montufar, I. Carrol, S. De Los Rios. Anesthesia in pregnant women with HELLP syndrome. Int J Gynecol Obstet 2001;74: 23-27
  19. P. Vigil-De Gracia. Acute fatty liver and HELLP syndrome: two distinct pregnancy disorders, Int J Gynecol Obstet, 2001;73:215-220