Maternal outcome following temporizing management of the (H)ELLP syndrome.

OBJECTIVE

The aim of the study was to describe the clinical progress and maternal outcome of the (H)ELLP syndrome following temporizing management.

METHODS

All women (n = 127) admitted in the Academic Medical Center in Amsterdam between 1984 and 1996 with (H)ELLP syndrome and a live fetus in utero were included. The patients were treated by temporizing management, including the use of antihypertensives and magnesium sulfate. The predominant indication for terminating pregnancy was fetal distress or fetal death, and not maternal condition.

MAIN OUTCOME MEASURES: Maternal mortality and morbidity.

RESULTS

All serious maternal complications occurred at the onset of the syndrome. Two mothers with HELLP syndrome died following a cerebral hemorrhage. The remaining patients recovered completely. Serious maternal morbidity occurred more often in cases of HELLP than in cases of ELLP syndrome. Seventy-nine (62%) women were not delivered after 3 days and 65 (51%) after 7 days.

CONCLUSIONS

Severe complications only occurred at the onset of (H)ELLP syndrome. It is unlikely that a more aggressive approach would have reduced maternal mortality or morbidity.