OALibJ  Vol.2 No.9 , September 2015
A Study of HELLP Syndrome among Cases of Pre-Eclampsia and Eclampsia: Incidence and Correlation of Laboratory Parameters
Abstract: Objective: To determine the incidence of HELLP syndrome amongst cases of Eclampsia and severe pre eclampsia admitted to our hospital and to study the correlation of laboratory parameters with the mean arterial pressure (MAP) and with each other. Method: 238 cases of severe pre eclampsia and eclampsia were studied for their clinical features, laboratory parameters and outcome. Cases were divided into two groups: non HELLP and complete HELLP for comparison of the maternal and perinatal outcome. The levels of Alanine Transaminase (ALT) were compared against other laboratory parameters for correlation. The mean arterial pressures (MAP) of the patients were computed to investigate whether its levels had any correlation with the derangement of ALT. Statistical analysis was done in SPSS software and spearman’s correlation was run for the laboratory parameters. Results: No significant difference was seen in the maternal and perinatal mortality in the two groups. ALT showed no correlation with MAP as with LDH, platelets and hemoglobin and a weak but significant correlation with the parameters of renal function. Conclusion: Our population shows a low incidence of HELLP syndrome; the hepatic dysfunction correlates with the renal dysfunction without any correlation with the MAP.
Cite this paper: Tiwari, P. , Bhalavi, S. , Nayak, S. and Tiwari, R. (2015) A Study of HELLP Syndrome among Cases of Pre-Eclampsia and Eclampsia: Incidence and Correlation of Laboratory Parameters. Open Access Library Journal, 2, 1-6. doi: 10.4236/oalib.1101853.

[1]   Sibai, B.M., Ramadan, M.K., Usta, I., Salama, M., Mercer, B.M. and Friedman, S.A. (1992) Maternal Morbidity and Mortality in 442 Pregnancies with Hemolysis, Elevated Liver Enzymes, and Low Platelets (HELLP Syndrome). Intensive Care Medicine, 18, 274-277.

[2]   Boujdaria, R., Nouira, S., Abroug, S., Souissi, M. and Najjar, M.F. (1992) Hellp Syndrome: Incidence and Maternal-Fetal Outcome—A Prospective Study. Intensive Care Medicine, 18, 274-277.

[3]   Curtin, W.M. and Weinstein, L. (1999) A Review of HELLP Syndrome. Journal of Perinatology, 19, 138-143.

[4]   Kappler, S., Ronan-Bentle, S. and Graham, A. (2014) Thrombotic Microangiopathies (TTP, HUS, HELLP). Emergency Medicine Clinics of North America, 32, 649-671.

[5]   Riedl, M., Fakhouri, F., Le Quintrec, M., Noone, D.G., Jungraithmayr, T.C., Fremeaux-Bacchi, V. and Licht, C.. (2014) Spectrum of Complement-Mediated Thrombotic Microangiopathies: Pathogenetic Insights Identifying Novel Treatment Approaches. Semin Thromb Hemost, 40, 444-464.

[6]   Shenkman, B. and Einav, Y. (2014) Thrombotic Thrombocytopenic Purpura and Other Thrombotic Microangiopathic Hemolytic Anemias: Diagnosis and Classification. Autoimmunity Reviews, 13, 584-586.

[7]   Haram, K., Svendsen, E. and Abildgaard, U. (2009) The HELLP Syndrome: Clinical Issues and Management. A Review. BMC Pregnancy Childbirth, 9, 8.

[8]   M artin Jr., J.N., Rose, C.H. and Briery, C.M. (2006) Understanding and Managing HELLP Syndrome: The Integral Role of Aggressive Glucocorticoids for Mother and Child. American Journal of Obstetrics & Gynecology, 195, 914-934.

[9]   Padden, M.O. (1999) HELLP Syndrome: Recognition and Perinatal Management. American Family Physician, 60, 829-839.

[10]   Heilmann, L. (1987) Blood Rheology and Pregnancy. Baillière’s Clinical Haematology, 1, 777-799.

[11]   Kapil, U. and Bhadoria, A.S. (2014) Prevalence of Folate, Ferritin and Cobalamin Deficiencies amongst Adolescent in India. Journal of Family Medicine and Primary Care, 3, 247-249.

[12]   Haram, K., Mortensen, J.H. and Nagy, B. (2014). Genetic Aspects of Preeclampsia and the HELLP Syndrome. Journal of Pregnancy, 2014, Article ID: 910751.

[13]   Audibert, F., Friedman, S.A., Frangieh, A.Y. and Sibai, B.M. (1996) Clinical Utility of Strict Diagnostic Criteria for the HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelets) Syndrome. American Journal of Obstetrics and Gynecology, 175, 460-464.

[14]   Alasztics, B., Kukor, Z., Pánczél, Z., Valent, S. (2012) The Pathophysiology of Preeclampsia in View of the Two-Stage Model. Orvosi Hetilap, 153, 1167-1176.

[15]   Saftlas, A.F., Rubenstein, L., Prater, K., Harland, K.K., Field, E. and Triche, E.W. (2014) Cumulative Exposure to Paternal Seminal Fluid Prior to Conception and Subsequent Risk of Preeclampsia. Journal of Reproductive Immunology, 101-102, 104-110.

[16]   Triche, E.W., Harland, K.K., Field, E.H., Rubenstein, L.M. and Saftlas, A.F. (2014) Maternal-Fetal HLA Sharing and Preeclampsia: Variation in Effects by Seminal Fluid Exposure in a Case-Control Study of Nulliparous Women in Iowa. Journal of Reproductive Immunology, 101-102, 111-119.

[17]   Robertson, S.A., Bromfield, J.J. and Tremellen, K.P. (2003) Seminal “Priming” for Protection from Pre-Eclampsia—A Unifying Hypothesis. Journal of Reproductive Immunology, 59, 253-265.

[18]   Vasiljević, N., Vasiljević, M. and Plećas, D. (1996) The Role of Nutritional Factors in Pre-Eclampsia and Eclampsia. Srpski Arhiv za Celokupno Lekarstvo, 124, 156-159

[19]   Roberts, J.M., Balk, J.L., Bodnar, L.M., Belizán, J.M., Bergel, E. and Martinezy, A. (2003) Nutrient Involvement in Preeclampsia. Journal of Nutrition, 133, 1684S-1692S.

[20]   Lam, C., Lim, K.H. and Karumanchi, S.A. (2005) Circulating Angiogenic Factors in the Pathogenesis and Prediction of Preeclampsia. Hypertension, 46, 1077-1085.