Diagnosis of HELLP syndrome. Where are we?

Abstract

Introduction: HELLP syndrome is a rapidly progressing condition which requires distinct diagnostic considerations. The goal of the study was to evaluate the means of diagnosis applied for HELLP syn- drome and assess their impact on maternal and neonatal outcomes. Methods: A retrospective observational cohort study was carried out using medical records of tertiary perinatology center with the diagnosis of HELLP syndrome from the period of time between 2005 and 2013. Patients were grouped by Mississippi-Triple-Class system. Means of diagnosis and treatment outcomes were analyzed within those groups. Results: Among the 45 patients with HELLP syndrome included in the study, 58% (n = 26) fit the HELLP syndrome criteria and 42% (n = 19) had partial HELLP syndrome. Within the HELLP syndrome group 30.8% of patients fit Class 1, 53.8% and 15.4% had Class 2 and Class 3 HELLP syndrome respectively. Severe pre- eclampsia was present in 96.2% of HELLP syndrome and 100% partial HELLP syndrome cases. However the level of blood pres- sure did not correlate with the severity of patients’ condition (P = 0.656, v 2 = 18.835). Treatment was based on the Mississippi protocol. Mean time from admission to delivery was 27.5 (27.5) and 38,6 (65) h in HELLP and partial HELLP group respectively. Maternal complications developed in 4.4% of all cases and in the HELLP group 15.38% of cases ended in perinatal death. Conclusions: HELLP syndrome is a multiorganic disorder whose diagnosis should be based on biochemical laboratory evidence. Vigi- lance in recognition of HELLP syndrome and appropriate treatment are essential to ensure the better maternal and neonatal outcome.