HELLP-syndrome as a life-threatening condition: current clinical considerations
https://doi.org/10.17749/2313-7347.2019.13.1.035-042
Abstract
HELLP-syndrome is an extremely serious complication of pregnancy with a high risk of adverse perinatal and maternal outcomes. Aim: to study the clinical course, maternal and perinatal complications in pregnant women with HELLP-syndrome. Materials and methods. We conducted a retrospective study on clinical records of 28 births by women with HELLP-syndrome and 35 women with severe preeclampsia (PE) without HELLP-syndrome manifestations. The diagnostic criteria of the HELLP-syndrome in patients with severe РЕ were based on the symptoms of intravascular hemolysis typically manifested in arterial hypertension, proteinuria, and generalized edema. Results. The classical three symptoms of HELLP-syndrome were noted only in 64.2 % of cases, and the mono-symptomatic course - in 35.7 % of cases. The total triad of HELLP-syndrome (hemolysis, thrombocytopenia, elevation of hepatic enzymes) was recorded in 42.8 % of cases. The most common form was the typical HELLP-syndrome, then - the ELLP-syndrome (elevation of liver enzymes and thrombocytopenia) - 57.2 % of cases; an isolated elevation of hepatic enzymes in severe PE was found in 53.5 % of cases, thrombocytopenia in severe PE - in 64.2 % of cases. A high incidence of adverse perinatal outcomes was also found: premature births (64.2 %) and antenatal fetal death (21.4 %). Conclusion. In the above clinical situations, the diagnostic judgement should be pointed towards the HELLP-syndrome; accordingly, the adequate obstetric management should be initiated to prevent the development of life-threatening complications in both the mother and the fetus.
About the Authors
E. V. TimokhinaRussian Federation
Elena V. Timokhina - MD, PhD, Professor, Department of Obstetrics and Gynecology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
Scopus Author ID: 25958373500
A. N. Strizhakov
Russian Federation
Alexander N. Strizhakov - MD, PhD, Professor, Academician of RAS, Head of Department of Obstetrics and Gynecology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Scopus Author ID: 7005104683
V. S. Belousova
Russian Federation
Vera S. Belousova - PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
A. G. Aslanov
Russian Federation
Alexander G. Aslanov - PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
I. M. Bogomazova
Russian Federation
Irina M. Bogomazova - PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
N. V. Afanasyeva
Russian Federation
Natalya V. Afanasyeva - PhD, Deputy Chief Physician for Obstetrics and Gynecology, CCH n.a. S.S. Yudin, Moscow Healthcare Department.
4 Kolomenskiy passage, Moscow 115446.
Ju. A. Samoylova
Russian Federation
Julia A. Samoylova - PhD, Head of Department of Pregnancy Pathology, CCH n.a. S.S. Yudin, Moscow Healthcare Department.
4 Kolomenskiy passage, Moscow 115446.
S. M. Ibragimova
Russian Federation
Sapiyat M. Ibragimova - Postgraduate Student, Department of Obstetrics, Gynecology and Perinatology, Faculty of General and Preventive Medicine, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
A. M. Kechina
Russian Federation
Anna M. Kechina - Medical Student, I.M. Sechenov First MSMU HM of RF.
8/2 Trubetskaya St., Moscow 119991.
Tel.: +7(499)7823045.
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Review
For citations:
Timokhina E.V., Strizhakov A.N., Belousova V.S., Aslanov A.G., Bogomazova I.M., Afanasyeva N.V., Samoylova J.A., Ibragimova S.M., Kechina A.M. HELLP-syndrome as a life-threatening condition: current clinical considerations. Obstetrics, Gynecology and Reproduction. 2019;13(1):35-42. (In Russ.) https://doi.org/10.17749/2313-7347.2019.13.1.035-042

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