Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome.

OBJECTIVE To evaluate the prognostic factors affecting morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome cases. METHODS We retrospectively evaluated, 2245 cases who delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Turkey between January and December 2002. Ninety-three cases had severe preeclampsia, 26 cases eclampsia, 19 cases HELLP syndrome, and 6 cases with eclampsia and HELLP syndrome were included in this study. The pregnancy induced hypertension cases were evaluated retrospectively for socioeconomic status, obstetrical history, biochemical parameters, and maternal complications. RESULTS The incidence of preeclampsia was 20.1% (453/2245), the incidence of severe preeclampsia, eclampsia, and HELLP syndrome was 6.4% (144/2245). These ratios are higher than that reported in the English literature. The complication rate was 38% in severe preeclampsia cases. Among the severe preeclampsia cases, 32 had eclampsia (22.1%), and 25 had HELLP syndrome (17.3%). CONCLUSION The most important biochemical marker for maternal mortality is bilirubin levels. Maternal mortality was statistically higher in cases with jaundice. Also, there was a statistically significant relation between maternal complications and liver function tests, lactate dehydrogenase levels, and low platelet levels.

[1]  D. Reingardienė.  [Preeclampsia and eclampsia]. , 2003, Medicina.

[2]  P. Parfrey,et al.  Familial risk of preeclampsia in Newfoundland: a population-based study. , 2002, Journal of the American Society of Nephrology : JASN.

[3]  John R Barton,et al.  Late postpartum eclampsia: a preventable disease? , 2002, American journal of obstetrics and gynecology.

[4]  ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. , 2002, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[5]  P. Gracia.  Pregnancy complicated by pre-eclampsia-eclampsia with HELLP syndrome. , 2001 .

[6]  J. Jiménez López,et al.  [Pre-eclampsia and eclampsia. Experience at the Centro Médico Nacional de Torreón]. , 2001, Ginecologia y obstetricia de Mexico.

[7]  R. Marín,et al.  [Severe maternal complications associated with pre-eclampsia: an almost forgotten pathology?]. , 2001, Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia.

[8]  D. Murphy,et al.  MORTALITY AND MORBIDITY ASSOCIATED WITH EARLY-ONSET PREECLAMPSIA , 2000, Hypertension in pregnancy.

[9]  K. Ramin.  High Risk Pregnancy: Management Options , 1995 .

[10]  S C Robson,et al.  High Risk Pregnancy: Management Options , 1995 .

[11]  C. Redman,et al.  Eclampsia in the United Kingdom , 1994, BMJ.

[12]  D. Wlody,et al.  Hypertension in pregnancy. , 1992, The New England journal of medicine.

[13]  L. Chesley.  History and Epidemiology of Preeclampsia - Eclampsia , 1984, Clinical obstetrics and gynecology.

[14]  D. Bartolek,et al.  Preeclampsia and eclampsia. , 1981, The Western journal of medicine.

[15]  V. K. Vasin.  OBSTETRIC PRACTICE , 1916, Veterinariia.

[16]  R. Kinglake.  On Obstetric Practice , 1815, The London medical and physical journal.