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

Saudi Med J. 2006 Jul;27(7):1015-8.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Bilirubin / blood
  • Biomarkers / blood
  • Eclampsia / epidemiology
  • Eclampsia / pathology*
  • Female
  • HELLP Syndrome / epidemiology
  • HELLP Syndrome / pathology*
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Liver Function Tests
  • Middle Aged
  • Platelet Count
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / pathology*
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Turkey / epidemiology

Substances

  • Biomarkers
  • L-Lactate Dehydrogenase
  • Bilirubin