A Cross Sectional Study Of Hellp Syndrome In Pregnancy Complicated By Severe Pre Eclampsia In A Tertiary Care Hospital

ABSTRACT

Background and objectives Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a dangerous and life threatening complication in severe preeclampsia. It remains as an important cause of maternal and perinatal morbidity and mortality globally. The objective of this study was to find out the incidence of HELLP syndrome in pregnancies complicated by severe pre eclampsia and to assess the maternal and perinatal morbidity and mortality in women with HELLPsyndrome secondary to severe pre eclampsia. Methodology A one year Cross sectional study was conducted in the labour room of KLE Academy of Higher Education and Research (KAHER), Belagavi for the period of one year from January 2016 to December 2016. Ethical clearance was obtained from the JNMC Institutional Ethics committee. The primary objective was to determine the incidence of severe pre eclampsia and HELLPsyndrome in patients of severe pre eclampsia. The secondary objective was to study the associated maternal and perinatal morbidity and mortality. Results During the study period, a total of 6236 number of deliveries were conducted in the hospital. Among them, 312 (5%) pregnant women developed severe preeclampsia and 33 women developed HELLPsyndrome(10.57%). The mean age was 25.18±3.81 years. Labour was induced in 21.21% of the women. Majority (66.67%) of the women had vaginal delivery, while the rest had caesarean section (33%) . The most common indication for LSCS was HELLP 81.82%. Majority (84.85%) of the women had complications of HELLP alone while 9.09% of the women had HELLP syndrome associated with abruption. The mean birth weight was 2.27±0.69 Kgs. All cases had live births. The requirement of NICU admission was noted in 18.18% and the most common cause of NICU admission was Meconium aspiration syndrome with fetal distress (50%). The perinatal mortality rate was 16.67%. Conclusion and interpretation HELLPsyndrome is one of the rare complications of severe pre eclampsia. This study shows 5% incidence of severe preeclampsia and incidence of HELLP syndrome in pregnancy complicated by severe preeclampsia as 10.57%. The incidence in our study is high as our hospital is a tertiary care centre that receives referral cases (high risk with poor prognosis) from North Karnataka for further management.