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Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome?
Acta Obstet Gynecol Scand. 2007; 86(6):648-51.AO

Abstract

BACKGROUND

To determine the risk factors for adverse maternal outcome among women with HELLP syndrome.

METHODS

Sixty-one pregnancies with hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome diagnosed antenatally were reviewed between 2003 and 2005. Maternal outcomes analyzed included eclampsia, abruptio placentae, disseminated intravascular coagulopathy (DIC), acute renal failure, need for transfusion of blood products, cesarean delivery and maternal death. Risk factors included maternal age, parity, gestational age at diagnosis, mean arterial blood pressure, headache, visual changes, nausea-vomiting, epigastric pain, blood platelet count (<or=50,000 versus >50,000 cells/mm3), and peak serum levels of aspartate aminotransferase.

RESULTS

Eclampsia was present in 52%, abruptio placentae in 11%, and DIC in 8% of 61 women with HELLP syndrome. 23% women required transfusion of blood products, 15% had acute renal failure, and 73% had cesarean section. Women with eclampsia had significantly more headache, nausea-vomiting, visual changes and epigastric pain (p<0.05). Transfusion was significantly more frequent among women with blood platelet counts <or=50,000 cells/mm3 (33 versus 21%; p<0.05). Women with a platelet count <or=50,000 cells/mm3 had a higher rate of DIC compared to women with a platelet count >50,000 cells/mm3 (33.3 versus 3.8%; p<0.05). In women with acute renal failure and abruptio placentae, there were no significant differences in all the variables studied between those with and without these complications.

CONCLUSIONS

Clinical symptoms, such as headache, visual changes, epigastric pain and nausea-vomiting, are more predictive than laboratory parameters for adverse maternal outcomes.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Woman Health Education and Research Hospital, Ankara, Turkey. sabri99@excite.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17520393

Citation

Cavkaytar, Sabri, et al. "Are Clinical Symptoms More Predictive Than Laboratory Parameters for Adverse Maternal Outcome in HELLP Syndrome?" Acta Obstetricia Et Gynecologica Scandinavica, vol. 86, no. 6, 2007, pp. 648-51.
Cavkaytar S, Ugurlu EN, Karaer A, et al. Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? Acta Obstet Gynecol Scand. 2007;86(6):648-51.
Cavkaytar, S., Ugurlu, E. N., Karaer, A., Tapisiz, O. L., & Danisman, N. (2007). Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? Acta Obstetricia Et Gynecologica Scandinavica, 86(6), 648-51.
Cavkaytar S, et al. Are Clinical Symptoms More Predictive Than Laboratory Parameters for Adverse Maternal Outcome in HELLP Syndrome. Acta Obstet Gynecol Scand. 2007;86(6):648-51. PubMed PMID: 17520393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? AU - Cavkaytar,Sabri, AU - Ugurlu,Evin Nil, AU - Karaer,Abdullah, AU - Tapisiz,Omer Lutfi, AU - Danisman,Nuri, PY - 2007/5/24/pubmed PY - 2007/9/12/medline PY - 2007/5/24/entrez SP - 648 EP - 51 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 86 IS - 6 N2 - BACKGROUND: To determine the risk factors for adverse maternal outcome among women with HELLP syndrome. METHODS: Sixty-one pregnancies with hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome diagnosed antenatally were reviewed between 2003 and 2005. Maternal outcomes analyzed included eclampsia, abruptio placentae, disseminated intravascular coagulopathy (DIC), acute renal failure, need for transfusion of blood products, cesarean delivery and maternal death. Risk factors included maternal age, parity, gestational age at diagnosis, mean arterial blood pressure, headache, visual changes, nausea-vomiting, epigastric pain, blood platelet count (<or=50,000 versus >50,000 cells/mm3), and peak serum levels of aspartate aminotransferase. RESULTS: Eclampsia was present in 52%, abruptio placentae in 11%, and DIC in 8% of 61 women with HELLP syndrome. 23% women required transfusion of blood products, 15% had acute renal failure, and 73% had cesarean section. Women with eclampsia had significantly more headache, nausea-vomiting, visual changes and epigastric pain (p<0.05). Transfusion was significantly more frequent among women with blood platelet counts <or=50,000 cells/mm3 (33 versus 21%; p<0.05). Women with a platelet count <or=50,000 cells/mm3 had a higher rate of DIC compared to women with a platelet count >50,000 cells/mm3 (33.3 versus 3.8%; p<0.05). In women with acute renal failure and abruptio placentae, there were no significant differences in all the variables studied between those with and without these complications. CONCLUSIONS: Clinical symptoms, such as headache, visual changes, epigastric pain and nausea-vomiting, are more predictive than laboratory parameters for adverse maternal outcomes. SN - 0001-6349 UR - https://www.unboundmedicine.com/medline/citation/17520393/Are_clinical_symptoms_more_predictive_than_laboratory_parameters_for_adverse_maternal_outcome_in_HELLP_syndrome L2 - https://doi.org/10.1080/00016340601185384 DB - PRIME DP - Unbound Medicine ER -