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

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. 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. 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%]. 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

relationship between pregnancy induced hypertension and congenital thrombophilia

To investigate the relationship between some thrombophilic parameters and pregnancy induced hypertension [PIH]. The study took place at the Department of Obstetrics and Gynecology, Perinatology Unit, Faculty of Medicine, Cukurova University, Turkey, between January 2002 and December 2002. We evaluated 202 patients. Patients were divided into 2 groups: control group comprised 102 normotensive patients >20 weeks of pregnancy without any medical or pregnancy related pathologies and the study group comprised 100 patients over 20 weeks of pregnancy with PIH. These hypertensive patients were divided into 6 sub-groups as follows: eclampsia, severe preeclampsia, preeclampsia, chronic hypertension plus superimposed preeclampsia, eclampsia, and hemolysis elevated liver enzymes and thrombocytopenia [HELLP] syndrome. In all cases, complete blood count, antithrombin III, protein S levels, factor V Leiden mutation, prothrombin 20210 mutation, methylenetetrahydrofolate reductase [MTHFR] 677 mutation and homocysteine levels were studied. Statistical analysis of the data was carried out using SPSS version 11.0 program. In comparing the 2 groups we used Mann-Whitney U tests. In comparing the PIH subgroups we used Kruskal-Wallis tests. The levels of p<0.05 were accepted as statistically significant. Antithrombin III deficiency, protein C deficiency, hyperhomocysteinanemia were found to be associated with PIH groups. But protein S deficiency, and homozygote factor V Leiden mutation, prothrombin 20210, MTHFR 677 mutation were not found to be related with PIH