Prospective Observational Study to Determine Perinatal Outcome in Patients with HELLP Syndrome

Abstract

Background: HELLP syndrome is a serious obstetric complication in pregnancy characterised by hemolysis, elevated liver enzymes and low platelet count. Incidence is 9.7% and prevalence ranges from 0.5-0.9%. The aim of the study was to study the incidence, different clinical presentations and diagnosis of HELLP syndrome in Pre eclampsia and eclampsia and to analyse the severity, complications, maternal and perinatal outcome. Aim & Objective: To determine perinatal outcome in patients diagnosed with HELLP syndrome. Methodology: The clinical trial was conducted for a period of two years OBGY department of Bharati Vidyapeeth University, Pune. It is an prospective observational study where a total number of 30 cases of HELLP syndrome above 28 weeks of gestational age were admitted in Bharati hospital during the study period of 24 months. Data analysis was done and appropriate statistical tests were used. Results: A total of 30 females with HELLP syndrome visiting tertiary care teaching hospital were included in the study. The mean age of the patients was ranging between 21 to 43 years. The mean gestation age was ranging between 28 to 38 weeks. Majority 13 (43.3%) of women were primigravida, followed by G2A1 7(23.3%), G2P1L1 3(10.0%), G3P1L1 and G3P1L1A1 2(6.7%) each, G3A2, G4P1D1A2 and G2P2L1 1(3.3%)each. There were total 8 (26.6%), 7 (23.4%) of HELLP syndrome patients had pre eclampsia and GDM, respectively, one and 2 of these patients were also having hypothyroidism respectively. 2 (6.7%) each patients had hypothyroidism, anemia and chronic hypertension. While, eclampsia, epilepsy, IVF and gestational hypertension were reported in 1 (3.3%) patient each. Majority of women with HELLP syndrome had brisk (24 (80%) type of deep tendon reflexes, followed by exaggerated 3 (10%) and there were 3 (10%) women with normal reflexes. Majority of women the mode of delivery was emergency LSCS (60%), mean of the APGAR score at 1 minandat 5 minutes was recorded among 25 (83.33%) patients. The NICU admission was require damong 14/30 (46.7%) of new born, while it was not required in 16 (53.3%) of new born. Conclusion: This study was done to intensify our efforts to reduce pre eclampsia with HELLP syndrome by undergoing regular antenatal care, early detection of pre eclampsia and its prompt management and early detection of complications with timely intervention.