HELLP-syndrome. Difficulties in diagnosis and therapy of a severe form of preeclampsia.

As in cases of HELLP-Syndrome both the mother and the fetus are at greater risk we analyzed retrospectively the clinical records of 14 patients concerning changes of typical laboratory parameters, clinical course including time of correct diagnosis, as well as fetal and maternal complications. The death of one woman represents a maternal mortality rate of 7.1% whereas perinatal mortality ranged 20% due to 3 intrauterine fetal losses. In our study group the mean time interval from onset of clinical symptoms like pain, vomiting etc. until admission to our department was 8.2 days (median: 4 days). Incorrect interpretation of abdominal pain as the leading symptom, the absence of signs of toxemia and missing or only moderate changes of the typical laboratory parameters cause this delay in correct diagnosis, which presumably has the major negative impact on the unfavorable obstetrical data in cases of HELLP-Syndrome.