[Significance of early laboratory diagnosis for obstetrical procedures in severe gestoses and the HELLP syndrome].

HELLP syndrome is a severe complication of preeclampsia, incalculable in its course and involving high risk for mother and fetus. Over a period of three years and eight months a total of 24 patients with HELLP syndrome were treated at Göttingen University Gynecological Clinic and the Gynecological Clinic of Munich Technical University. In all cases the correct diagnosis had already been made by the referring physician or by the obstetrician on admission, taking laboratory parameters into account. The chief clinical symptom was upper abdominal pain, All of the patients presented with thrombocytopenia and elevated liver enzymes. The signs of hemolysis derived from the increased bilirubin concentrations and the LDH; in 13 cases fragmentocytes were detected in the peripheral blood smear. No indications of a pronounced DIG were found. The mean time elapsed between hospitalization and delivery was six hours (0.5-40 hours); 22 patients were delivered within 24 hours. Cesarean section was performed in all cases. The mean gestational age at the time of birth was 35 weeks (25-38). Three of 24 children died prepartially; with the surviving infants no major problems arose in the postnatal course. In 19 cases the abdominal cesarean delivery and clinical course were without complications. Reoperation, in two cases combined with a puerperal hysterectomy, was necessary in three patients, due to subfascial and intraperitoneal or retroperitoneal hematomas.(ABSTRACT TRUNCATED AT 250 WORDS)