A Study of Maternal and Perinatal Outcomes in Pregnancy Complicated by HELLP Syndrome

Abstract

Background
Pregnancy can result in a serious complication known as HELLP which comprises of haemolysis, elevated levels of liver enzymes, and low platelet count. The aetiology of HELLP syndrome is still unknown. HELLP syndrome affects 6–12% of women with preeclampsia or
eclampsia, making up to around 0.5% of all pregnancies . Compared to preeclampsia, HELLP syndrome is considered a high-risk condition for both the mother and neonate and its occurrence is associated with increased maternal and perinatal morbidity and mortality. The objective of this study was to investigate the incidence of HELLP syndrome in cases of pre-eclampsia and eclampsia and document its associated maternal and perinatal. complications. Materials and methods This is a retrospective study that utilizes data collected from 55 patients diagnosed with HELLP syndrome at the Department of Obstetrics and Gynecology, Hi-tech medical college
& hospital, Bhubaneswar between January 2020 and December 2022. The study included women who were diagnosed with severe preeclampsia or eclampsia and were beyond 28 weeks of pregnancy with abnormal laboratory results. Outcomes were presented as either mean (SD) or median (IQR) for continuous variables and as proportion for categorical variables. A p-value of <0.05 was considered statistically significant.
Results Out of 2175 deliveries, 272 (12.5%) were complicated by pre-eclampsia (194 cases) and eclampsia (78 cases). Of these cases, 55 (20.2%) were diagnosed with HELLP syndrome Majority of the subjects were aged 25 to 35 years (54.5%) followed by 18-25 years (34.5%). Around 40% of the subjects with HELLP reported “any” maternal complication. Among these, the most common were disseminated intravascular coagulation (DIC) (31.8%) followed by abruptio placentae (27.3%) and post-partum haemorrhage (22.7%). A total of 44 (80.0%) neonates were born preterm (<37 weeks of gestation). A total of 40% of the neonates were born with birth weight of 1500 to 2500 g. The perinatal death was observed in 10 (18.2%) with 4 stillbirths and 6 first-week deaths.
Conclusions HELLP Syndrome is a complication of pre-eclampsia and eclampsia with potentially adverse maternal and neonatal/perinatal outcomes. Early diagnosis and prompt intervention are crucial to prevent further progression of the underlying pathophysiology and potential complications.