title: [Maternal morbidity and perinatal mortality in HELLP syndrome. Multicentric studies in intensive care units in Buenos Aires area].
abstract: We analyzed the clinical characteristics, complications, severity, and maternal and fetal survival of patients suffering from HELLP syndrome (Hemolysis, Elevated Liver enzymes level, Low Platelet count) requiring admission to the intensive care unit in four hospitals from Buenos Aires area, Argentina. Data was revised in the charts from March 1997 to March 2003 and 62 patients were included in the study. During the second half of pregnancy or immediate puerperal period, diagnostic criteria were defined on the basis of preeclampsia and the following laboratory abnormalities: platelet count nadir <150,000/mm3, serum hepatic aminotransferases >70 UI/l, and serum lactic dehydrogenase >600 UI/l, total bilirubin >1.2 mg/dl and/or periferical blood smear with hemolysis. The mean maternal age was 28 +/- 8 years; parity 2.7 +/- 2.3; gestational age 33 +/- 4 weeks. According to platelet count, 23 cases were identified to class 1, 29 to class 2 and the rest to Martin's class 3. There were 16 eclamptic patients. The platelet count was 67,604 +/- 31,535/mm3; alanine aminotransferase 271 +/- 297 UI/l; aspartate aminotransferase 209 +/- 178 UI/l; serum lactic dehydrogenase 1444 +/- 1295 UI/l; serum creatininine levels 1.1 +/- 0.8 mg/dl. Forty-one patients had diverse degree of renal function damage, renal dialysis and plasmapheresis was required in one female. Respiratory failure due to pulmonary edema was observed in four patients. All obstetric patients survived. There were four perinatal deaths. In our population sample, low rate of life-threatening maternal complications and low perinatal mortality were observed.
authors.affiliation: Unidad de Cuidados Intensivos de Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina. criticalobstetric@hotmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Malvino
authors.forename: María
authors.initials: M
authors.lastname: Muñoz
authors.forename: Claudia
authors.initials: C
authors.lastname: Ceccotti
authors.forename: Gustavo
authors.initials: G
authors.lastname: Janello
authors.forename: Diego
authors.initials: D
authors.lastname: Mc Loughlin
authors.forename: Alberto
authors.initials: A
authors.lastname: Pawlak
authors.forename: Pablo
authors.initials: P
authors.lastname: Desmery
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Lopez Gaston
mesh_terms: D000328:Adult; D001118:Argentina / Q000453:epidemiology; D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007362:Intensive Care Units; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D012189:Retrospective Studies; D016019:Survival Analysis