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HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: onset at < or =28.0 weeks' gestation.
Am J Obstet Gynecol. 2000 Dec; 183(6):1475-9.AJ

Abstract

OBJECTIVE

Our purpose was to determine whether the onset of the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome in women at < or =28.0 weeks' gestation is associated with an increased risk of adverse maternal and perinatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age.

STUDY DESIGN

Sixty-four patients with either the HELLP syndrome (n = 32) or severe preeclampsia but absent HELLP syndrome laboratory test results (n = 32), admitted at < or =28.0 weeks' gestation between July 1, 1992, and April 30, 1999, were studied. Maternal and perinatal outcomes were compared between the 2 groups. Statistical analysis was performed by the Student t test and the Fisher exact test.

RESULTS

There were no significant differences between the 2 groups regarding African-American race (59% vs 75%), nulliparity (50% vs 56%), or the use of corticosteroids (59% vs 78%). There were no maternal deaths. One woman with the HELLP syndrome had a liver hematoma. The rate at which transfusion of blood products was required was significantly greater in women with the HELLP syndrome than in those with severe preeclampsia only (25% vs 3%; P <.05). There were no significant differences between the 2 groups with respect to eclampsia (16% vs 13%), abruptio placentae (6% vs 9%), disseminated intravascular coagulopathy (13% vs 0%), pulmonary edema (13% vs 6%), acute renal failure (3% vs 0%), pleural effusion (3% vs 3%), or ascites (6% vs 16%). No significant differences were found between the 2 groups with respect to neonatal death (11% vs 17%), respiratory distress syndrome (78% vs 86%), or composite neonatal morbidity.

CONCLUSIONS

Except for the need for transfusion of blood products in women with the HELLP syndrome, onset at < or =28.0 weeks' gestation is not associated with an increased risk of adverse maternal or neonatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age.

Authors+Show Affiliations

Division of Maternal-Fetal Medicine, University of Tennessee, Memphis, TN, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11120513

Citation

Haddad, B, et al. "HELLP (hemolysis, Elevated Liver Enzymes, and Low Platelet Count) Syndrome Versus Severe Preeclampsia: Onset at < or =28.0 Weeks' Gestation." American Journal of Obstetrics and Gynecology, vol. 183, no. 6, 2000, pp. 1475-9.
Haddad B, Barton JR, Livingston JC, et al. HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: onset at < or =28.0 weeks' gestation. Am J Obstet Gynecol. 2000;183(6):1475-9.
Haddad, B., Barton, J. R., Livingston, J. C., Chahine, R., & Sibai, B. M. (2000). HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: onset at < or =28.0 weeks' gestation. American Journal of Obstetrics and Gynecology, 183(6), 1475-9.
Haddad B, et al. HELLP (hemolysis, Elevated Liver Enzymes, and Low Platelet Count) Syndrome Versus Severe Preeclampsia: Onset at < or =28.0 Weeks' Gestation. Am J Obstet Gynecol. 2000;183(6):1475-9. PubMed PMID: 11120513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome versus severe preeclampsia: onset at < or =28.0 weeks' gestation. AU - Haddad,B, AU - Barton,J R, AU - Livingston,J C, AU - Chahine,R, AU - Sibai,B M, PY - 2000/12/20/pubmed PY - 2001/2/28/medline PY - 2000/12/20/entrez SP - 1475 EP - 9 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 183 IS - 6 N2 - OBJECTIVE: Our purpose was to determine whether the onset of the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome in women at < or =28.0 weeks' gestation is associated with an increased risk of adverse maternal and perinatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age. STUDY DESIGN: Sixty-four patients with either the HELLP syndrome (n = 32) or severe preeclampsia but absent HELLP syndrome laboratory test results (n = 32), admitted at < or =28.0 weeks' gestation between July 1, 1992, and April 30, 1999, were studied. Maternal and perinatal outcomes were compared between the 2 groups. Statistical analysis was performed by the Student t test and the Fisher exact test. RESULTS: There were no significant differences between the 2 groups regarding African-American race (59% vs 75%), nulliparity (50% vs 56%), or the use of corticosteroids (59% vs 78%). There were no maternal deaths. One woman with the HELLP syndrome had a liver hematoma. The rate at which transfusion of blood products was required was significantly greater in women with the HELLP syndrome than in those with severe preeclampsia only (25% vs 3%; P <.05). There were no significant differences between the 2 groups with respect to eclampsia (16% vs 13%), abruptio placentae (6% vs 9%), disseminated intravascular coagulopathy (13% vs 0%), pulmonary edema (13% vs 6%), acute renal failure (3% vs 0%), pleural effusion (3% vs 3%), or ascites (6% vs 16%). No significant differences were found between the 2 groups with respect to neonatal death (11% vs 17%), respiratory distress syndrome (78% vs 86%), or composite neonatal morbidity. CONCLUSIONS: Except for the need for transfusion of blood products in women with the HELLP syndrome, onset at < or =28.0 weeks' gestation is not associated with an increased risk of adverse maternal or neonatal outcomes in comparison with the risk for women with severe preeclampsia but without the HELLP syndrome at a similar gestational age. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/11120513/HELLP__hemolysis_elevated_liver_enzymes_and_low_platelet_count__syndrome_versus_severe_preeclampsia:_onset_at_<_or_=28_0_weeks'_gestation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(00)17462-9 DB - PRIME DP - Unbound Medicine ER -