Clinical symptoms and laboratory parameters do not predict adverse maternal and fetal outcomes in HELLP

Abstract

Aim To determine the ability of clinical symptoms and laboratory parameters to predict adverse outcomes in HELLP syndrome. Methods A retrospective chart analysis of pregnant women diagnosed with HELLP during a 5 year (2005–2009) period at a tertiary care perinatal center. The diagnosis of HELLP was based on Sibai’s criteria and categorized based on the Mississippi classification. Clinical symptoms and the presence of maternal and fetal adverse events were noted from the records. Receiver operator characteristics, likelihood ratios and adjusted odds ratios were used to determine the predictive ability of clinical symptoms and laboratory parameters. Results The medical records of 74 pregnant women with HELLP were analyzed. Any adverse (maternal and/or fetal) event was present in 40 (54.1%, 95% CI: 42.4%, 65.7%) pregnancies with HELLP syndrome in this population. One in four pregnancies with HELLP resulted in an adverse maternal event and 35% of pregnancies with HELLP in an adverse fetal event. There were no maternal deaths in this series and the perinatal mortality rate was 149 per 1000 births. Clinical symptoms or laboratory parameters were not predictive of adverse events. Conclusions Further research is needed to identify factors that can predict adverse perinatal outcomes in HELLP.