Incidence and clinical course of HELLP syndrome in pregnant women / 대한내과학회지

ABSTRACT

BACKGROUND: Although HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a serious medical complications including coagulopathy, hypertension, hepatic and renal failures, and pulmonary edema in pregnant women, the data about HELLP syndrome were rarely reported in the medical journal in Korea. METHODS: Nineteen cases of HELLP syndrome were retrospectively studied out of 16,910 pregnant women from January 1998 to March 2004 at Uijongbu St. Mary's Hospital. We analyzed incidence, clinical symptoms, laboratory findings, maternal and clinical complications and clinical course of HELLP syndrome. RESULTS: The incidence of HELLP syndrome was 0.27% (19/16,910) in total pregnant women and 4.15% (19/458) in women with preeclampsia. All patients had evidence of hemolysis and serum aspartate aminotransferase level >or= 70 IU/L, and platelet counts Hospital, serious maternal complications included acute renal failure (n=3), pulmonary edema (n=2), disseminated intravascular coagulopathy (n=2), postpartum bleeding (n=4). There was no maternal death. Fetal complications included placental disruption (n=2), and intrauterine growth retardation (n=5). Fetal death occurred in 2 cases.

CONCLUSION:

This data suggest that HELLP syndrome is not uncommon in women with preeclampsia and it represents poor maternal and fetal outcomes. Therefore, in order to decrease maternal and fetal morbidities, cooperation between internists and obstetric doctors is very important.