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Comparisons of maternal and perinatal outcomes in Taiwanese women with complete and partial HELLP syndrome and women with severe pre-eclampsia without HELLP.
J Obstet Gynaecol Res. 2006 Dec; 32(6):550-8.JO

Abstract

AIM

To analyze the variations between maternal complications and perinatal outcome among women with complete hemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome, partial HELLP syndrome, and women with severe pre-eclampsia and normal laboratory tests. We also examine the effect of corticosteroid therapy for treatment of HELLP.

METHODS

In this retrospective study, six patients with complete HELLP syndrome and 46 with partial HELLP syndrome, were compared and contrasted with 212 patients with severe pre-eclampsia but without HELLP syndrome.

RESULTS

In Protocol 1, multiple organ dysfunction syndrome (MODS) was the strongest morbidity factor associated with patients among complete HELLP, partial HELLP, and severe pre-eclampsia. After post-hoc analysis, disseminated intravascular coagulation (DIC) was the significant outcome variable between complete and partial HELLP. In Protocol 2, after adjustment, we found that MODS (adjusted OR, 15.2, 95% CI, 6.18-35.53; P < 0.001); Apgar score less than 5 at 1 minute (adjusted OR, 2.17, 95% CI, 0.94-5.01; P = 0.069) and DIC (adjusted OR, 9.51, 95% CI, 1.68-53.7, P = 0.011) remained significantly associated with HELLP syndrome. There was a favorable outcome found in the complete HELLP group. Neither the dexamethasone group nor the aggressive therapy group could benefit from the treatment protocol.

CONCLUSION

The different categories of HELLP syndrome, the protocol 1 and protocol 2 have been noted as differential effects on pregnancy outcome. MODS and DIC would be two significant outcome variables and corticosteroid therapy may not benefit HELLP patients.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. cliu1218.tw@yahoo.com.twNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17100816

Citation

Liu, Ching-Ming, et al. "Comparisons of Maternal and Perinatal Outcomes in Taiwanese Women With Complete and Partial HELLP Syndrome and Women With Severe Pre-eclampsia Without HELLP." The Journal of Obstetrics and Gynaecology Research, vol. 32, no. 6, 2006, pp. 550-8.
Liu CM, Chang SD, Cheng PJ, et al. Comparisons of maternal and perinatal outcomes in Taiwanese women with complete and partial HELLP syndrome and women with severe pre-eclampsia without HELLP. J Obstet Gynaecol Res. 2006;32(6):550-8.
Liu, C. M., Chang, S. D., Cheng, P. J., & Chao, A. S. (2006). Comparisons of maternal and perinatal outcomes in Taiwanese women with complete and partial HELLP syndrome and women with severe pre-eclampsia without HELLP. The Journal of Obstetrics and Gynaecology Research, 32(6), 550-8.
Liu CM, et al. Comparisons of Maternal and Perinatal Outcomes in Taiwanese Women With Complete and Partial HELLP Syndrome and Women With Severe Pre-eclampsia Without HELLP. J Obstet Gynaecol Res. 2006;32(6):550-8. PubMed PMID: 17100816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparisons of maternal and perinatal outcomes in Taiwanese women with complete and partial HELLP syndrome and women with severe pre-eclampsia without HELLP. AU - Liu,Ching-Ming, AU - Chang,Shuenn-Dyh, AU - Cheng,Po-Jen, AU - Chao,An-Shine, PY - 2006/11/15/pubmed PY - 2007/1/11/medline PY - 2006/11/15/entrez SP - 550 EP - 8 JF - The journal of obstetrics and gynaecology research JO - J Obstet Gynaecol Res VL - 32 IS - 6 N2 - AIM: To analyze the variations between maternal complications and perinatal outcome among women with complete hemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome, partial HELLP syndrome, and women with severe pre-eclampsia and normal laboratory tests. We also examine the effect of corticosteroid therapy for treatment of HELLP. METHODS: In this retrospective study, six patients with complete HELLP syndrome and 46 with partial HELLP syndrome, were compared and contrasted with 212 patients with severe pre-eclampsia but without HELLP syndrome. RESULTS: In Protocol 1, multiple organ dysfunction syndrome (MODS) was the strongest morbidity factor associated with patients among complete HELLP, partial HELLP, and severe pre-eclampsia. After post-hoc analysis, disseminated intravascular coagulation (DIC) was the significant outcome variable between complete and partial HELLP. In Protocol 2, after adjustment, we found that MODS (adjusted OR, 15.2, 95% CI, 6.18-35.53; P < 0.001); Apgar score less than 5 at 1 minute (adjusted OR, 2.17, 95% CI, 0.94-5.01; P = 0.069) and DIC (adjusted OR, 9.51, 95% CI, 1.68-53.7, P = 0.011) remained significantly associated with HELLP syndrome. There was a favorable outcome found in the complete HELLP group. Neither the dexamethasone group nor the aggressive therapy group could benefit from the treatment protocol. CONCLUSION: The different categories of HELLP syndrome, the protocol 1 and protocol 2 have been noted as differential effects on pregnancy outcome. MODS and DIC would be two significant outcome variables and corticosteroid therapy may not benefit HELLP patients. SN - 1341-8076 UR - https://www.unboundmedicine.com/medline/citation/17100816/Comparisons_of_maternal_and_perinatal_outcomes_in_Taiwanese_women_with_complete_and_partial_HELLP_syndrome_and_women_with_severe_pre_eclampsia_without_HELLP_ L2 - https://doi.org/10.1111/j.1447-0756.2006.00468.x DB - PRIME DP - Unbound Medicine ER -