Cardiopulmonary morbidity as a complication of severe preeclampsia HELLP syndrome.
OBJECTIVE
To profile the types and frequencies of cardiopulmonary morbidity encountered in patients with severe preeclampsia with or without hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome).


METHODS
We initiated a retrospective study of 979 patients with severe preeclampsia with and without HELLP syndrome. Types of cardiopulmonary morbidity were analyzed among the three classes of HELLP syndrome and severe preeclampsia without HELLP syndrome.


RESULTS
Cardiopulmonary morbidity occurred in 7.6% of study patients. As a group, patients with cardiopulmonary complications were more likely to have cesareans (11% vs 6%, p = 0.019) earlier in gestation (1366 +/- 700 gm birth weight versus 1734 +/- 892 gm birth weight, p = 0.021), with higher peak postpartum blood pressures (< 0.001) and with more abnormal laboratory values indicative of multisystem disease, compared with patients without this complication. Patients with cardiopulmonary complications required almost twice as long to achieve diuresis as comparison patients (22 +/- 23 hours versus 12 +/- 11 hours, p < 0.001).


CONCLUSIONS
The probability of cardiopulmonary complications increases significantly when patients develop class 1 HELLP syndrome. Of all cardiopulmonary complications, acute lung injury/acute respiratory distress syndrome is most specific to class 1 HELLP syndrome. Transient renal dysfunction is closely related to cardiopulmonary morbidity.
Terrone
D A
DA
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Isler
C M
CM
May
W L
WL
Magann
E F
EF
Norman
P F
PF
Martin
J N
JN
D002585:Cesarean Section; D005260:Female; D017359:HELLP Syndrome / Q000150:complications*; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000150:complications*; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012189:Retrospective Studies