Perinatal outcome with HELLP/partial HELLP complicating hypertensive disorders of pregnancy. An Indian rural experience.
A total of 615 women with hypertensive disorders during pregnancy were the study subjects. Of these, 145 (23.58%) women had HELLP or partial HELLP (only one or two of the three components H,EL, LP). Overall, eight (1.3%), i.e. five out of 399 primigravida (1.2%) and three of the 216 multigravida (1.3%), had complete HELLP and the remaining 137 (22.2%) had partial HELLP. Of the 399 primigravida with hypertensive disorders, 107 (26.5%) had partial HELLP, statistically significantly more (p<0.002) than the 30 out of the 216 (13.8%) multigravida. In 210 (44.6%) out of 470 women with hypertension without HELLP/partial HELLP, labour was induced and the perinatal mortality rate (PMR) was 138.9 (58.06 in term and 363.63 in pre-term cases), and in the other 260 women in whom labour was not induced, PMR was 96.15 (in term cases 74.07 and in pre-term 120). Among the women with HELLP/partial HELLP (145), out of the 64 women in whom labour was induced, the PMR was 359.37 (235.29 in term and 500 in pre-term) and of those in whom labour was not induced (81), PMR was 209.87 (106 in term cases and 352.94 in pre-term). All the eight women with the full HELLP syndrome had labour induced, the PMR in these cases was 500. Overall, in women with HELLP/partial HELLP, the PMR was 275.8 and in the remainder with hypertensive disorders without HELLP/partial HELLP, it was 114.89.
Chhabra
S
S
Department of Obstetrics and Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Maharashtra, India. chhabra_s@rediff.com
Qureshi
A
A
Datta
N
N
D005260:Female; D017359:HELLP Syndrome / Q000503:physiopathology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data; D008428:Maternal Mortality; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012424:Rural Population; D050497:Stillbirth / Q000453:epidemiology