[Maternal and perinatal surgical complications in low platelet count for HELLP syndrome in severe preeclampsia-eclampsia in intensive care].Ginecol Obstet Mex. 2003 Aug; 71:379-86.GO
The preeclampsia is the first cause of maternal morbility, with increase in the obstetric complications when it is associated to HELLP syndrome, for the low platelets that even involves to the neonate. This study was carried out in the patients accepted in the intensive Adults Cares Unit in the period of one year, surgical complications and the perinatal results were determined in women with low platelet count for HELLP syndrome in preeclampsia-eclampsia. Three groups were formed according to the platelets account and then were analyzed using chi square to determine association among these groups of patients, as well as mean and standard deviation (M +/- DE) to describe results. Forty patients were studied with low platelets by HELLP syndrome in preeclampsia-eclampsia, where the distribution for the group with platelets < 50,000 were 12 patients (30%), in the group among 51,000-100,000 of 18 cases (45%), and of 101,000-150,000 were of 10 cases (25%). The mean of gestas was of 2.3 +/- 1.2, more frequent delivery was for cesarean section in 39 cases (97.5%) and a single case for vaginal via (2.5%), a maternal death was presented (8.3%). The surgical reintervention was observed with more frequency in the group of < 50,000 platelets, the most frequent cause in these reinterventions was the hipovolemic shock. Also in this group the perinatal mortality was presented in 3 cases (25%) and the asphyxia at the birth with Apgar < 6 was presented in 5 cases (41.7%). A bigger morbility was observed inversely proportional to the account platelets, being the renal failure the cause most frequent of this morbility in the three groups. The low platelets account contribute in a direct way in the obstetric complications, since there are more surgical reinterventions, with bled in the transsurgical and increase in the days of intrahospitalary stay. Also with smaller account platelet, there are bigger prematural index, asphyxia and perinatal mortality in the newborn of mothers with HELLP syndrome.