Vol. 4, Issue 4 (2018)
Clinical study of HELLP syndrome in tertiary care Hospital
Author(s): Dr. Vivek Hoskeri, Dr. R Patange, Dr. Nitin Kshirsagar, Dr. Sanjay Patil, Dr. Anjali Patil, Dr. Snehal Shinde
Abstract: Introduction: Every woman’s wish is to end her pregnancy with a healthy baby and a healthy mother. Unfortunately, some women develop pregnancy induced hypertension sometimes ending in its dreaded complications. PIH is one among the leading causes of maternal and perinatal morbidity and mortality. It has higher prevalence in nulliparous and is present as a maternal syndrome, characterized by arterial hypertension generally with Proteinuria, and a foetal syndrome, with foetal growth restriction and amniotic fluid reduction. It may have several systemic manifestations, variable degrees of severity and either an early onset with maternal and foetal morbidity, or a late onset, near term, with less severity and reduced foetal compromise. Preeclampsia is characterized by hypertension (systolic and diastolic blood pressure of ≥ 140 and 90 mm Hg, respectively, on two occasions, at least 6 hours apart) and Proteinuria (protein excretion of ≥ 300 mg in a 24 h urine collection, or a dipstick of ≥ 1+), developing after 20 weeks of gestation in previously normotensive women. The analysis of the physio-pathological process shows that its origins are related to an immunological process associated with a defective and insufficient placentation.Although the placental origins of the disease are largely accepted maternal or foetal predisposing factors are also considered when an early onset or a high severity are present. Aim and Objectives: To study the maternal outcome and perinatal outcome in pregnancy complicated with HELLP syndrome. Materials and Methods: An observational study identified 50 cases of HELLP syndrome from a total of 7352 deliveries over a 22 months period. Results: The mean maternal age was 26.73 years with HELLP syndrome diagnosed. There were 29 cases of partial HELLP syndrome & 21 cases of complete HELLP syndrome. The average platelet was 53000 with elevated liver enzymes in all cases.23 (46%) were posted for Caesarean section and 27(54%) delivered by vaginal route. There were 4 maternal deaths, 13 stillbirth and 7 neonatal deaths. Conclusion: HELLP syndrome is an obstetric complication. Early diagnosis and treatment is main stay of management. Use of corticosteroids improves in lab parameters, better maternal and perinatal outcome.