title: Perinatal outcomes in severe preeclampsia-eclampsia with and without HELLP syndrome.
abstract: OBJECTIVE
  Our purpose was to find out and compare perinatal outcomes in pregnancies complicated by severe preeclampsia-eclampsia with and without HELLP syndrome.
  
  
  METHODS
  Clinical and laboratory findings, and perinatal-neonatal outcomes of all pregnants with severe preeclampsia, eclampsia and HELLP have been prospectively recorded. Results were compared by means of Student's t test, chi2 analysis and Fisher's exact test as appropriate.
  
  
  RESULTS
  Among 367 consecutive severe preeclampsia, 106 (29%) had HELLP syndrome, 261 (71%) had severe preeclampsia and eclampsia. Mean gestational age and birth weight at delivery in severe preeclampsia without HELLP syndrome and in HELLP syndrome were 34.1 +/- 6.1 vs. 33.0 +/- 5.8 weeks (p = 0.119) and 1,886 +/- 764 vs. 1,724 +/- 776 g (p = 0.063), respectively. Comparing overall fetal mortality (4.6 vs. 10.3%, p = 0.009) and perinatal mortality (8.0% vs. 16.8%, p = 0.026) in severe preeclampsia-eclampsia and HELLP syndrome, respectively, there were statistically significant differences. But when analyses were performed according to gestational age before and after 32nd gestational week, the difference of perinatal mortality between the two groups was non-significant (p = 0.644 and p = 0.250), suggesting borderline difference. The most common contributing factor for fetal death after 32nd week was due to abruptio placenta without prenatal follow-up. Neonatal morbidity and neonatal mortality (4.8 vs. 6.3%, p = 0.905) in severe preeclampsia-eclampsia and HELLP syndrome respectively were similar and the difference was statistically nonsignificant.
  
  
  CONCLUSIONS
  Perinatal mortality and neonatal morbidity-mortality according to gestational age before and after the 32nd week were similar in HELLP syndrome compared with severe preeclampsia-eclampsia without HELLP but overall fetal mortality was higher in HELLP syndrome with no regular prenatal care.
authors.affiliation: Maternal and Fetal Unit, Istanbul SSK Bakirkoy Women and Children Hospital, Istanbul, Turkey. ahmetgul@ttnet.net.tr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gul
authors.forename: Altan
authors.initials: A
authors.lastname: Cebeci
authors.forename: Halil
authors.initials: H
authors.lastname: Aslan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Polat
authors.forename: Aykut
authors.initials: A
authors.lastname: Ozdemir
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Ceylan
mesh_terms: D000328:Adult; D004461:Eclampsia / Q000150:complications*; D005260:Female; D046689:Fetal Mortality; D005865:Gestational Age; D017359:HELLP Syndrome / Q000150:complications*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies