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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. Timokhina
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
Russian 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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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
City Clinical Hospital named after S.S. Yudin, Moscow Healthcare Department
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
City Clinical Hospital named after S.S. Yudin, Moscow Healthcare Department
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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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
I.M. Sechenov First Moscow State Medical University, Health Ministry of Russian Federation
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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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)