HELLP Syndrome- Maternal and Perinatal Outcome in a Tertiary Care Institution

Abstract

A B S T R A C T BACKGROUNDHELLP syndrome characterized by haemolysis, elevated liver enzymes and low platelet count is an acronym coined by Dr Louis Weinstein in 1982 1 . It occurs in about 0.5-0.9% of all pregnancies and in 10-20% cases with severe preeclampsia. HELLP syndrome is associated with substantial risk for the mother and foetus. There is always a controversy regarding the definition, diagnosis, cause and management of this enigmatic disease. METHODSThis was a retrospective study conducted in the Department of O&G, Government Medical College, Thrissur, Kerala. Women with more than 24 weeks of gestational age diagnosed as HELLP Syndrome by abnormal laboratory parameters, during the study period were analyzed for their demographic variables, clinical presentation and obstetric and perinatal outcome. RESULTSOf the 55 patients in the study, 24 % had some complications. Postpartum haemorrhage was the most common complication followed by DIC. Caesarean hysterectomy was done in one case following severe atonic PPH. There was one case of maternal death, who developed DIC and acute renal failure. 89.1 % of the babies were complicated by intrauterine growth restriction and 78.2% were preterm. CONCLUSIONSHELLP syndrome is an alarming diagnosis which has high maternal and perinatal morbidity and mortality. Outcome of HELLP syndrome depends on its severity, timely intervention, availability of blood and blood products and tertiary care hospital facilities. In spite of recent advances in our health care system, more efforts and further skilled care are required for satisfactory decline in adverse maternal and foetal outcome.