[Maternal and perinatal prognosis affected by the time of termination of pregnancy in patients with hemolysis elevated liver enzymes and low platelet syndrome].

OBJECTIVE

To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome.

METHODS

57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled. According to the length from the time diagnoses confirmed to the time of delivery, patients were divided into 3 groups; group I, within 24 hours, group II, 24 to 48 hours and group III, over 48 hours. Complications, maternal and perinatal mortality were analyzed retrospectively between different groups.

RESULTS

Maternal and perinatal mortality were 7% and 11% in group I, 16% and 21% in group II, 64% and 73% in group III with significant differences between group III and group I or group III and group II (P < 0.05). Incidence of DIC, ARF and neonatal asphyxia was 11%, 4% and 19% in group I compared with 55%, 36% and 64% in group III, significantly higher in group III than those in group I (P < 0.05). Incidence of ARF in maternal was 4% in group I and 37% in group II with significant difference (P < 0.05).

CONCLUSION

Pregnancy should be terminated as soon as possible once diagnosis of HELLP is confirmed with optimal time within 48 hours.