Clinical Study of HELLP Syndrome and It's Outcome at Pravara Rural Hospital, Loni

Dr Pragya Isser, Dr Sai Borawake
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Abstract

Background: HELLP syndrome, a severe pregnancy complication characterized by hemolysis, elevated liver enzymes, and low platelet count, occurs in 0.5 to 0.9% of all pregnancies and in 10–20% of severe preeclampsia cases. It poses significant risks to both mother and fetus, presenting diagnostic and therapeutic challenges. Patients often experience epigastric or right upper quadrant pain, hypertension, proteinuria, fatigue, nausea, vomiting, sudden weight gain, and headaches. HELLP syndrome typically occurs in the second and third trimesters (27-37 weeks) and 15–30% of cases present postpartum. The exact causes remain unclear but may involve placental origins, autoimmune factors, gene mutations, or fatty acid oxidation disorders. Aims and Objectives: To analyze the clinical profile of HELLP syndrome cases and to assess maternal and perinatal outcomes, including morbidity and mortality. Material and Methods: This prospective cross-sectional study was conducted in the Obstetrics and Gynecology department at Pravara Rural Hospital, Loni, involving 45 patients with severe preeclampsia and eclampsia above 28 weeks of gestation diagnosed with HELLP syndrome. Patients were admitted to the ICU, and detailed histories and examinations were recorded. Patients were divided into two groups: those with HELLP syndrome (Group A) and those without (Group B). Results: Group A had a higher representation in the 20-22 age bracket, while Group B had more members aged 22-24. Cesarean sections were more common in Group A, whereas vaginal deliveries were more frequent in Group B. Blood pressure readings were higher in Group A. Maternal complications, such as abruption placentae, DIC, hepatic infarction, acute renal failure, and ascites, were more frequent in Group A, as were neonatal complications like IUGR, preterm delivery, neonatal thrombocytopenia, and RDS. Conclusion: The study reveals significant differences between patients with and without HELLP syndrome. Group A included younger patients, more first-time mothers, and a higher incidence of complications and mortality. These findings highlight the need for tailored management strategies for severe preeclampsia/eclampsia, especially in those with HELLP syndrome, to improve maternal and neonatal outcomes.
洛尼市普拉瓦拉乡村医院对 HELLP 综合征及其结果的临床研究
背景:HELLP综合征是一种严重的妊娠并发症,以溶血、肝酶升高和血小板计数低为特征,发生率占所有妊娠的0.5%至0.9%,占重度子痫前期病例的10%至20%。它对母亲和胎儿都有很大风险,给诊断和治疗带来挑战。患者通常会出现上腹部或右上腹疼痛、高血压、蛋白尿、乏力、恶心、呕吐、体重骤增和头痛等症状。HELLP 综合征通常发生在孕期的第二和第三季度(27-37 周),15%-30% 的病例在产后出现。确切病因尚不清楚,但可能涉及胎盘起源、自身免疫因素、基因突变或脂肪酸氧化紊乱。目的和目标:分析 HELLP 综合征病例的临床特征,评估产妇和围产期的结局,包括发病率和死亡率。材料与方法:这项前瞻性横断面研究在洛尼市普拉瓦拉农村医院妇产科进行,涉及 45 名妊娠 28 周以上重度子痫前期和子痫并被诊断为 HELLP 综合征的患者。患者被送入重症监护室,并详细记录了病史和检查结果。患者被分为两组:HELLP 综合征患者(A 组)和非 HELLP 综合征患者(B 组)。结果A 组中 20-22 岁年龄段的患者较多,而 B 组中 22-24 岁年龄段的患者较多。产妇并发症,如胎盘早剥、DIC、肝梗塞、急性肾功能衰竭和腹水,以及新生儿并发症,如 IUGR、早产、新生儿血小板减少症和 RDS,在 A 组中更为常见。结论研究显示,HELLP 综合征患者与非 HELLP 综合征患者之间存在明显差异。A 组患者较年轻,初产妇较多,并发症和死亡率较高。这些研究结果突出表明,有必要为重度子痫前期/子痫,尤其是患有 HELLP 综合征的重度子痫前期/子痫患者量身定制管理策略,以改善孕产妇和新生儿的预后。
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