PP152. Eclampsia concurrent with HELLP syndrome - A sixteen-year clinical experience in an academic medical center.

INTRODUCTION

Hypertensive disorders represent the most common complication among pregnant women, affecting 6-8% of gestations in the United States [1]. In Asia, There are many pregnant women die of eclampsia and severe preeclampsia. And 99% of these deaths occur in low income countries [2]. Eclampsia is defined as the occurrence of seizures in a woman with preeclampsia that cannot be attributed to other causes. HELLP syndrome represents a severe form of preeclampsia/eclampsia characterized by hemolysis, elevated liver enzymes, and low platelets [3]. The reported incidence of HELLP syndrome in association with eclampsia ranges from 10.8% to 32.1%. [4,5] And the incidence of eclampsia in association with HELLP syndrome ranges from 6% to 52% [6,7].

OBJECTIVES

The purpose of this study was to determine the characteristics of eclampsia concurrent with HELLP syndrome and maternal complications during the study period.

METHODS

We retrospectively collected the data from the log book of our birth center between January 1994 and December 2010. There were 22 eclampsia patients concurrent with HELLP syndrome as compared with 46 patients with eclampsia and without HELLP syndrome. We analyzed the characteristics of 22 patients concurrent with HELLP syndrome and investigated the maternal complications, as well as fetal prognosis of them. Fisher exact test and Chi-square test were used in categorized variables. The univariate analysis of neonatal outcome was used to calculate the odds ratio and 95% confidence interval.

RESULTS

The significant maternal outcome variables in patient with eclampsia concurrent with HELLP syndrome included the following: disseminated intravascular coagulation (DIC) (OR, 9.214, 95% confidence interval, 2.19-38.86, p=0.002); hypoxic encephalopathy (OR,3.467, 95% confidence interval, 1.03-11.68, p=0.045) multiple organ dysfunction syndrome (MODS)( OR, 30.83, 95% confidence interval, 7.35-129.37, p<0.001) would associate with the contributions to the maternal complications.

CONCLUSION

The complexity of maternal complications was associated with eclampsia patient concurrent with HELLP syndrome.