[Factors related to the diagnosis of HELLP syndrome in patients with severe preeclampsia].

BACKGROUND

Each year, around 50,000 women die from preeclampsia-eclampsia worldwide. Thus, hypertensive disorders during pregnancy are public health problems in both developed and developing countries.

OBJECTIVE

To identify prognosis factors associated with HELLP syndrome in patients with severe preeclampsia.

MATERIAL AND

METHODS

A retrospective, observational, cross-sectional, and analytical study was carried out. It included patients that suffered from severe preeclampsia, with and without HELLP syndrome. They were hospitalized at the Division of Obstetrics Dr. Manuel Gea González General Hospital, from January 1st, 1995 to January 1st, 2000 (study group). Only clinical files of patients with severe preeclampsia, without convulsions, HELLP syndrome, or who had not died during the days spent at the hospital were included in the control group; within at least 72 subsequent hours to the pregnancy termination. The connection of HELLP syndrome with the following variables was assessed in the control group: gestational age, maternal age, infant formula, prenatal control, hypertensive disorder history, headache, tinnitus, phosphen, nausea, vomiting, epigastric pain, edema, hyperreflexia, blood pressure values, hepatic biometry, platelet count, blood chemistry with hepatic function.

RESULTS

Right upper quadrant or epigastric pain was the most important independent prognosis factor. There were significant differences in the admission laboratory values between those with HELLP syndrome and those without acute complications of preeclampsia.

CONCLUSIONS

Although the contribution of right upper quadrant or epigastric pain to the risk status of a pregnant patient is difficult to quantify, it can be used to assess whether the patient is at high risk for development of HELLP syndrome.