[Hemolysis, elevated liver enzymes, and low platelet count syndrome].
HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome is a severe, life-threatening pregnancy pathology, which occurs in 0.2-0.8% of all pregnancies, and approximately 10% (2-20%) of pregnancies are complicated with severe preeclampsia. This syndrome usually develops in the third trimester of pregnancy in preeclamptic patients, sometimes it occurs in the second trimester of pregnancy, and very rarely HELLP syndrome may develop within 48-72 hours after delivery. Diagnosis is complicated as there are no specific clinical signs, therefore, this syndrome may be confused with other pathologies like acute fatty liver of pregnancy, idiopathic thrombocytopenia, hemolytic uremic syndrome, appendicitis, and etc. The patients with HELLP syndrome should be treated in the tertiary care hospital, where appropriate diagnostics and multidisciplinary help for mother and fetus can be assured. When the syndrome was described for the first time, L. Weinstein recommended prompt delivery as the only possible treatment. Current studies show that conservative treatment of patients with HELLP syndrome is safe, without an increase in morbidity and mortality. That is why now many authors agree that treatment approach should be based on the estimated gestational age and the condition of the mother and fetus.
Adukauskiene
Dalia
D
Clinic of Intensive Care, Kaunas University of Medicine, Lithuania.
Vizgirdaite
Venta
V
Rimaitis
Kestutis
K
Aliuskeviciene
Asta
A
D000328:Adult; D002585:Cesarean Section; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D017359:HELLP Syndrome / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007745:Labor Onset; D008099:Liver / Q000201:enzymology; D015337:Multicenter Studies as Topic; D036801:Parturition; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D005938:Glucocorticoids