Factors affecting maternal and perinatal outcomes in HELLP syndrome: evaluation of 126 cases
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Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
I R O G Canada, Inc
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objectives. To ascertain the characteristics, clinical features. and maternal fetal outcome in HELLP (hemolysis elevated liver enzymes, low platelets) syndrome at a tertiary referral center Material and Methods This was a cross-sectional study carried out at Dicle University between January 2004 and December 2008 in which the charts of 126 cases were retrieved retrospectively and data analyzed descriptively Results Of all deliveries 0 9% were complicated by HELLP syndrome Of the cases with HELLP syndrome 79 (62 6%) had preeclampsia. 28 (22 2%) had eclampsia and 19 (15 2%) had a diagnosis of HELLP syndrome The values of significant biochemical parameters (mean SI)) were documented as ALT (alanin aminotransferase) 224 42 IU/I and ALP (after birth) 140 +/- 22. AST 379 +/- 23 IU/I and AST(I) 215 +/- 51. LDH (lactate dehydrogenase) 1418 +/- 67 IU/I and LDH(I) 875 +/- 16. together with the hematological parameters as platelet count (86 12 K/UI). urine protein (3 + in urine test stick) and albumin levels (2 +/- 0 9 g/dl) Eighty-six (68 25%) of the patients required albumin replacement Thirty-one (24 6%) cases welt: nullipara and 95 (75 4%) multipara. of which 32 women (25 4%) were in Class I. and 94 (74 6 %) in Class II of complete HELLP syndrome Regular antenatal examination was accomplished in a very small number of patients (12 25%) Fifty-eight (46 03%) patients requited transfusions with blood or blood products and 12 (9 5%) underwent laparotomy due to major intraabdominal bleeding. Magnesium sulphate to prevent convulsions and corticosteroids (12 mg betametazone) to enhance fetal lung maturity were administered Forty-four (34 9%) cases had vaginal delivery and 82 (65.1%) cesarean section: another 18 (14 2%) were with in utero stillbirth Fifteen babies (11 9%) died. 26 (20 63%) developed placental abruption. 14 (11 11%) acute renal insufficiency, and 13 (10.31%) postoperative subcutaneous hematomas Maternal mortality occurred in ten cases (7 93%) Conclusion HELLP syndrome is a pathology associated with a high incidence of maternal and perinatal complications Laboratory parameters in cases with HELLP syndrome are not efficient in detecting perinatal results. but can be used as risk denominators in evaluating maternal complications Therefore, lot patients with HELLP syndrome. standard antenatal follow-up protocols should be applied in order to obtain early diagnosis and improve the speed of transfer to obstetric departments with expertise in this field
Açıklama
Anahtar Kelimeler
Hellp, Preeclampsia, Eclampsia: High-Risk Pregnancy
Kaynak
Clinical and Experimental Obstetrics & Gynecology
WoS Q Değeri
Q4
Scopus Q Değeri
Q4
Cilt
37
Sayı
3
