Clinical Study of Maternal and Perinatal Outcome in Pregnancies Complicated By Hellp Syndrome

Abstract

Background & Objectives: HELLP syndrome is considered a placenta-instigated, liver-targeted acute inflammatory condition, with elements of disordered immunological processes. HELLP syndrome can be a great masquerader with vague and varied nature of presenting complaints making its diagnosis difficult. Delay in diagnosis may be life threatening with poor maternal and perinatal outcome. METHODS: 81 cases diagnosed of pregnancy induced hypertension(PIH) between May 2011 and April 2012 in department of obstetrics and gynaecology, Mamatha Medical College was included in the study. Of these 81, 18 cases fulfilled the criteria of HELLP. Maternal and perinatal outcome and also clinical and therapeutic factors affecting outcome were studied. Results: The incidence of pregnancy induced hypertension(PIH) during this period is 14.3%, of these 22.2% fulfilled the criteria of HELLP. Maximum incidence is among age group 20 – 30 years (88%). The incidence of maternal complications in our study was higher compared to Hemanth et al 3 , with incidence of pleural effusion/ ascites being highest (44.4%). The incidence of intra uterine deaths was 33.3% and the incidence of neonatal deaths was 16.6%. Interpretation & Conclusion: The reason for higher morbidity in our study is delay in identifying the problem by referring doctors. This study uncovers only the tip of the iceberg and HELLP syndrome in non PIH cases were not evaluated. Earlier diagnosis and intervention improves maternal and perinatal outcome