Descriptive analysis of women managed as hellp synd

Abstract

The acronym HELLP syndrome (haemolysis, elevated liver enzymes, and low platelets) is a serious complication of preeclampsia. It occurs in 0.5 to 0.9% of all pregnancies, it complicates 10-20% of pregnancies with severe pre-eclampsia or eclampsia and is associated with significant maternal and perinatal morbidity and mortality. Objectives To describe the demographic characteristics, haematological and biochemical findings and the risk factors in women with HELLP syndrome. We also describe the maternal complications and the perinatal outcomes in women with HELLP syndrome. Methods The present study is a retrospective, cross-sectional study of women with HELLP syndrome who delivered at Chris Hani Baragwanath Academic Hospital (CHBAH) between 01/052017 and 30/09/2017. The CHBAH is a tertiary and regional hospital performing approximately 19300 total deliveries and approximately 7718 caesarean sections (C/S) per annum. Women presenting with HELLP syndrome are assessed and managed according to the University of the Witwatersrand obstetrics protocol. Results-The total number of deliveries at Chris Hani Baragwanath Academic Hospital during the study period was 9095. Fifty-eight women had HELLP syndrome and were included in the study. The incidence of HELLP syndrome in the present study was 0.67%. Most women were multiparous. Acute kidney injury was found in 36.2%, disseminated intravascular coagulation in 6.8%, 22.4% needed blood transfusions, abruptio placenta occurred in 15.5% and eclampsia in 12%. There were 5.1% in need of ICU admission and caesarean section was performed in 81%. The maternal mortality rate was 2.9 per 100 000 live births. The perinatal mortality rate was 39.7 per 1000 live births.