First trimester prediction of HELLP syndrome

Oliveira, Natacha; Poon, Liona C.; Nicolaides, Kypros H.; Baschat, Ahmet

doi:10.1002/pd.4694

Cited by 18 publications

(14 citation statements)

References 22 publications

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“…This result suggested that HELLP syndrome may be a phenotype of severe preeclampsia or a pathological pathology that intersects with preeclampsia. 13,14 Preeclampsia is a pregnancy-specific disease that originates from the abnormal placental dysplasia and dysfunction. The previously studies speculated that HELLP syndrome was a systemic inflammatory disease.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Plasma Fibrinogen Level Predicts Postpartum Hemorrhage of Patients With HELLP Syndrome

Cui

2020

Clin Appl Thromb Hemost

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Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a serious complication of pregnancy. Postpartum hemorrhage indicates poor prognosis of pregnant women with HELLP syndrome. The aim of our study is to investigate the predictive value of coagulation markers for postpartum hemorrhage of pregnant women with HELLP syndrome. In a retrospective cohort study, 106 patients who were diagnosed as pregnant women with HELLP syndrome in Peking University Third Hospital from August 2010 to January 2017 were analyzed. The demographic characters of maternal and fetus, days of hospital stay, postpartum complications, and the laboratory tests of coagulation markers within 3 days before delivery were collected. In addition, 100 healthy pregnant women were collected as a control group. The result showed that the incidence of preeclampsia in pregnant women with postpartum hemorrhage was higher than that in pregnant women without hemorrhage (P ¼ .011). The level of fibrinogen (FIB) in postpartum hemorrhage pregnant women with HELLP syndrome was lower than that in nonpostpartum hemorrhage pregnant women with HELLP syndrome and healthy pregnant women (2.3 [1.68-2.81] vs 3.64 + 0.95, P ¼ .000; 2.3 [1.68-2.81] vs 4.48 + 0.62, P ¼ .000). Multivariate analysis showed that decreased FIB levels independently predicted the postpartum hemorrhage of pregnant women with HELLP syndrome (odds ratio ¼ 7.374, 95% confidence interval [CI], 1.551-35.05, P ¼ .012). The receiver operating characteristic curve showed that the area under the curve of FIB level when predicting postpartum hemorrhage is 0.841 (95% CI, 0.708-0.976). When the cutoff value of FIB was 3.04 g/L, the sensitivity was 90.90% and the specificity was75.80%. Therefore, the low level of prenatal FIB is a reliable biomarker to predict postpartum hemorrhage of pregnant women with HELLP syndrome, which make it useful for pregnant women with HELLP syndrome in guiding surveillance therapy and prognosis assessment.

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Section: Discussionmentioning

confidence: 99%

Prenatal Plasma Fibrinogen Level Predicts Postpartum Hemorrhage of Patients With HELLP Syndrome

Cui

2020

Clin Appl Thromb Hemost

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“…On the other hand, being primigest is considered a risk factor to the HELLP syndrome 9,10 , and the recurrence risk is 14-24% 11 . In face of headache, scotomas, nauseas and vomits, associated with arterial hypertension, the diagnostic hypothesis was set, which was confirmed in a few hours by laboratory tests, leading to the obtained therapeutic success.…”

Section: Discussionmentioning

confidence: 99%

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

Rodrigues¹,

Dias²,

Oliveira³

et al. 2017

Rev Pat Tocantins

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The HELLP syndrome – defined as haemolysis, elevated liver enzymes and thrombocytopenia – consists of an advanced stage of preeclampsia (PE), which can affect 0.6% of pregnancies and 4-12% of patients with severe PE. Being responsible for elevated maternal and perinatal mortality rates, it can present with general malaise, epigastralgia, right hypochondrium pain, nausea and vomits, headache, scotomas, associated with hypertension and proteinuria. Woman, 19 years old, primigest, admitted with 29 weeks of gestational age presenting with arterial hypertension (160/120 mmHg), headache, scotomas, nausea and vomits. She showed regular health status, pallid, closed, anterior and soft cervix, with no fluid losses, and inaudible fetal heart rate on the sonar. She was stabilized with intravenous hydration and antihypertensive drugs, the ultrasonography showed placental abruption and fetal death. An uneventfully caesarean operation was performed under general anaesthesia. Due to the low haemoglobin, haematocrit and platelet levels, she received blood transfusion, progressing with clinical and laboratory improvement. The pressure control was met by the use of methyldopa, nifedipine and pindolol, and she was discharged with a good health status at the 10th day of hospitalization, with scheduled return for reassessment. Keywords: HELLP syndrome, severe preeclampsia, fetal death, placental abruption. A síndrome HELLP – definida por hemólise, enzimas hepáticas elevadas e plaquetopenia – consiste em estágio avançado de pré-eclâmpsia (PE), podendo afetar 0,6% das gestações e 4-12% das pacientes com PE grave. Responsável por elevados índices de mortalidade materna e perinatal, pode se apresentar com mal estar geral, epigastralgia, dor em hipocôndrio direito, náuseas ou vômitos, cefaleia, escotomas, assoaciado a quadro hipertensivo e proteinúria. Mulher de 19 anos, primigesta, admitida com 29 semanas de idade gestacional com quadro de hipertensão arterial (160/120 mmHg), cefaleia, escotomas, náuseas e vômitos. Apresentava regular estado geral, hipocorada, colo uterino fechado, anterior, amolecido e sem perdas e batimento cardiofetal inaudível ao sonar. Estabilizada com hidratação venosa e anti-hipertensivos, foi realizada ultrassonografia que evidenciou descolamento prematuro de placenta e óbito fetal. Realizada cesariana sob anestesia geral sem intercorrências. Devido a baixos níveis de hemoglobina, hematócrito e plaquetas, foi hemotransfundida, apresentando melhora clínica e laboratorial. O controle pressórico foi atingido com uso de metildopa, nifedipina e pindolol, recebendo alta em bom estado geral no 10º dia de internação hospitalar com programação de retorno para reavaliação. Palavras-chave: Síndrome HELLP, Pré-eclâmpsia grave, óbito fetal, descolamento placentário.

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“…Demographic, clinical, maternal serum, ultrasonographic and Doppler factors can be combined to identify pregnancies with abnormal ongoing placental implantation and are thus at high risk for complications. Subsequent imbalance of angiogenic factors can be monitored via promising biophysical and biochemical markers . However, most cases of placenta‐related obstetric complications that occur during the third trimester, including fetal death, are not because of primary placenta pathologies but rather to acquired or secondary placental disorders (e.g.…”

Section: Prenatal Evaluation Of Placental Functionmentioning

confidence: 99%

In case you missed it: the Prenatal Diagnosis editors bring you the most significant advances of 2015

et al. 2016

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First trimester prediction of HELLP syndrome

Abstract: The majority of pregnancies that develop HELLP syndrome can be predicted in the first trimester. © 2015 John Wiley & Sons, Ltd.

Cited by 18 publications

References 22 publications

Prenatal Plasma Fibrinogen Level Predicts Postpartum Hemorrhage of Patients With HELLP Syndrome

Prenatal Plasma Fibrinogen Level Predicts Postpartum Hemorrhage of Patients With HELLP Syndrome

Hellp Syndrome With Placental Abruption and Fetal Death: A Case Report

In case you missed it: the Prenatal Diagnosis editors bring you the most significant advances of 2015

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