Abstract
PurposeTo investigate the clinical classification, pregnancy outcomes and risk factors of pregnant women with severe preeclampsia (SPE) complicated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.MethodsThe clinical data of 50 pregnant women diagnosed with SPE complicated with HELLP syndrome in our hospital from January 2014 to January 2021 were retrospectively analyzed, and they were selected as the observation group. An additional 50 maternities diagnosed with preeclampsia (PE) during the same period were selected as the control group. The clinical classification and pregnancy outcomes of pregnant women in the observation group were recorded. The age and gestational age of onset of pregnancy were recorded and compared between the two groups. Univariate analysis and multivariate logistic regression model were used to analyze the risk factors for its occurrence.ResultsAmong the 50 maternities in the observation group, there were 10 cases of type I, accounting for 20.00%; 35 cases of type II, accounting for 70.00%; 5 cases of type III, accounting for 10.00%. Partial 33 cases, the composition ratio of 66.00%; complete 17 cases, the composition ratio of 34.00%. Among the fetuses of 50 maternities in the observation group, 35 were premature, accounting for 70.00%; 13 had fetal growth restriction, accounting for 26.00%; and 2 died during perinatal period, accounting for 4.00%. Among the 50 maternities in the observation group, 48 cases were cesarean section, the composition ratio was 96.00%; 2 cases were induced labor, the composition ratio was 4.00%; there was no natural birth, the composition ratio was 0.00%. Univariate analysis showed that age, gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, PT, and FIB were all associated with the occurrence of SPE complicated with HELLP syndrome (P < 0.05). Multivariate logistic analysis showed that gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, and FIB were independent risk factors for SPE complicated with HELLP syndrome (P < 0.05).ConclusionSPE complicated with HELLP syndrome has significantly increased adverse pregnancy outcomes. Understanding its clinical classification is of great significance for the preventive application of platelet transfusion therapy and the selection of transfusion timing. Gestational age at onset and gestational age at termination of pregnancy are independent risk factors for its occurrence. Fully understanding the high-risk factors of HELLP syndrome, taking preventive measures in time, and carrying out targeted nursing can effectively improve the prognosis of pregnant women and reduce the risk of HELLP syndrome.
Highlights
IntroductionHELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a severe form of preeclampsia, which refers to a group of clinical syndromes typically characterized by hemolysis, elevated liver enzymes and low platelets in pregnant women on the basis of gestational hypertension or severe preeclampsia (SPE) and other diseases (1)
HELLP syndrome is a severe form of preeclampsia, which refers to a group of clinical syndromes typically characterized by hemolysis, elevated liver enzymes and low platelets in pregnant women on the basis of gestational hypertension or severe preeclampsia (SPE) and other diseases (1)
Exclusion criteria: primary hypertension combined with pregnancy; HELLP syndrome caused by diseases other than SPE; combined with other acute and chronic life-threatening diseases not caused by SPE; combined with gestational diabetes mellitus, acute fatty liver during pregnancy, autoimmune diseases; previous hematological diseases or cardiopulmonary, hepatic and renal insufficiency; patients transferred to hospital for treatment during treatment
Summary
HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a severe form of preeclampsia, which refers to a group of clinical syndromes typically characterized by hemolysis, elevated liver enzymes and low platelets in pregnant women on the basis of gestational hypertension or severe preeclampsia (SPE) and other diseases (1). The incidence of HELLP syndrome is relatively low, accounting for only 0.5–0.9% of the pregnant population (the incidence in China can be about 2.5%), but the clinical manifestations are diverse, the disease develops rapidly, and poses a greater risk to maternal and child health, and the lives of mothers and children are often endangered by delayed treatment, with a high rate of maternal and child complications and death (9). The clinical characteristics, pregnancy outcomes and risk factors of pregnant women with SPE complicated with HELLP syndrome were discussed and analyzed, in order to provide relevant reference materials for preventing and reducing the occurrence of HELLP syndrome
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