title: Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome.
abstract: OBJECTIVE
  To evaluate the prognostic factors affecting morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome cases.
  
  
  METHODS
  We retrospectively evaluated, 2245 cases who delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Turkey between January and December 2002. Ninety-three cases had severe preeclampsia, 26 cases eclampsia, 19 cases HELLP syndrome, and 6 cases with eclampsia and HELLP syndrome were included in this study. The pregnancy induced hypertension cases were evaluated retrospectively for socioeconomic status, obstetrical history, biochemical parameters, and maternal complications.
  
  
  RESULTS
  The incidence of preeclampsia was 20.1% (453/2245), the incidence of severe preeclampsia, eclampsia, and HELLP syndrome was 6.4% (144/2245). These ratios are higher than that reported in the English literature. The complication rate was 38% in severe preeclampsia cases. Among the severe preeclampsia cases, 32 had eclampsia (22.1%), and 25 had HELLP syndrome (17.3%).
  
  
  CONCLUSIONS
  The most important biochemical marker for maternal mortality is bilirubin levels. Maternal mortality was statistically higher in cases with jaundice. Also, there was a statistically significant relation between maternal complications and liver function tests, lactate dehydrogenase levels, and low platelet levels.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Balcali, Adana 01330, Turkey. scdemir@mail.cu.edu.tr
authors.forename: S Cansun
authors.initials: SC
authors.lastname: Demir
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Evruke
authors.forename: Fatma T
authors.initials: FT
authors.lastname: Ozgunen
authors.forename: Ibrahim F
authors.initials: IF
authors.lastname: Urunsak
authors.forename: Erdal
authors.initials: E
authors.lastname: Candan
authors.forename: Oktay
authors.initials: O
authors.lastname: Kadayifci
mesh_terms: D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004461:Eclampsia / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008111:Liver Function Tests; D008875:Middle Aged; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000473:pathology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014421:Turkey / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase; D001663:Bilirubin