Maternal and perinatal outcome in HELLP syndrome at VIMS, Ballari

Abstract

Objective: The aim of this study was to ascertain the presentation, diagnosis, severity and complications of HELLP syndrome and evaluation of the maternal and fetal outcome. Methods: Pregnancy induced hypertension (PIH) between 1 st February 2016 and 31 st January 2017 was included in the study. Diagnosed cases of HELLP syndrome were classified according to Tennesses criteria after assessing inclusion and exclusion criteria. The analysis of the data was done on all the patients diagnosed with HELLP syndrome. Results: The incidence of HELLP syndrome during the period was 1.14% of total deliveries and 3.82% of pregnancy induced hypertension (PIH). Majority (50%) patients belong to age group of 21 to 25 years. Mean age was 22.5 years. Most of them were primigravida (55%). Majority (52.5%) was in 36-40 weeks gestation and mean gestational age was 33.6 weeks. Head ache (56.25%) was the most common imminent symptom. Most of symptoms were nonspecific like malaise (50%), edema (45%), vomiting (20%) and epigastric pain (7.5%). Out of 80 patients of HELLP syndrome 19 delivered by LSCS and 61 delivered vaginally. Ascites (26.25%), PPH (25%) and placental abruption (22.5%) were the most common maternal complications in HELLP syndrome followed by acute renal failure (18.75%), pulmonary edema (12.5%), DIC (6.25%) and cerebrovascular accidents (6.25%). Maternal mortality in our study was 11.25%. Perinatal mortality was 41.25%. Conclusion: The reason for higher morbidity in our study is delay in identifying the problem by referring doctors. Earlier diagnosis and intervention improves maternal and perinatal outcome.