An analysis of HELLP syndrome cases: does platelet count predict adverse maternal and fetal outcomes in women with HELLP syndrome?

PURPOSE: To evaluate the maternal and fetal outcome in 44 pregnancies complicated with HELLP syndrome and to investigate the role of platelet counts in its prognosis.

METHODS

A retrospective analysis of the medical records of 44 patients with the diagnosis of hemolysis elevated liver enzymes and low platelet count between June 1997 and January 2009 was performed. The patients were divided into two groups according to blood platelet count: platelet count <50,000 mm(3) formed Group I and platelet count 50,000-100,000 mm(3) formed Group II. Clinical findings and laboratory characteristics, maternal complications, perinatal outcomes and comparison of maternal and fetal morbidity according to platelet counts were analyzed.

RESULTS

During the period of 12 years, 44 (0.54%) of 8,132 deliveries had HELLP syndrome. Among 44 patients, the most common complications were disseminated intravascular coagulopathy (18.2%), acute renal failure (15.9%), abruptio placentae (11.4%), and cerebral hemorrhage/infarction (11.4%). Maternal and perinatal mortality rates in HELLP syndrome were 9.1 and 40.9%, respectively. Aspartate aminotransferase levels were found to be statistically significantly higher in Group I (p = 0.04). While disseminated intravascular coagulopathy and acute renal failure were statistically significantly higher in Group I (p = 0.01; p = 0.03 respectively), fetal growth restriction was statistically significantly higher in Group II (p = 0.04).

CONCLUSIONS

HELLP syndrome is associated with high incidences of maternal and fetal morbidity and mortality and patients with low platelet counts might have a much increased risk.