Characteristic laboratory changes in pregnancies complicated by HELLP syndrome.
BACKGROUND
HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) is a severe, life-threatening form of preeclampsia. Its development is accompanied by significant increase in maternal, as well as fetal, morbidity, and mortality rates. It is essential, therefore, for obstetricians to be familiar with the disease.


METHODS
In the past 10 years, 107 patients were treated for HELLP syndrome in the intensive care unit (ICU) of the First Department of Obstetrics and Gynaecology, Semmelweis University. During this time, we studied the characteristic laboratory findings of the disease from the day of the diagnosis until the first few postpartum days.


RESULTS
HELLP syndrome was present in 0.37% of all women having live births. In our study, the liver enzymes AST, and LDH, and the level of total bilirubin (indicating the degree of hemolysis), and repeated thrombocyte counts were suitable for following the cases. The AST, LDH and bilirubin levels returned to normal between the third and seventh days postpartum. The platelet count passed the critical level of 100,000/microL on the third to fourth day.


CONCLUSIONS
We have found that the platelet count, LDH, AST, and total bilirubin levels proved to be useful indicators of the progression of HELLP syndrome.
Hupuczi
Petronella
P
First Department of Obstetrics and Gynaecology, Semmelweis University, Faculty of Medicine, Budapest, Hungary. hupuczi@noi1.sote.hu
Nagy
Bálint
B
Sziller
István
I
Rigó
Barbara
B
Hruby
Ervin
E
Papp
Zoltán
Z
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000097:blood; D036861:Delivery, Obstetric; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D017359:HELLP Syndrome / Q000097:blood*; D006461:Hemolysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology; D010976:Platelet Count; D011247:Pregnancy; D011256:Pregnancy Outcome; D013921:Thrombocytopenia / Q000097:blood
D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin