Long-term maternal and subsequent pregnancy outcomes 5 years after hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.
OBJECTIVE
To evaluate subsequent pregnancy outcome and impact of gestational age at onset of HELLP on long-term prognosis after HELLP over an average follow-up of 5 years


METHODS
One hundred twenty-eight patients with a history of HELLP filled out questionnaires and sent their medical records. Hemolysis, elevated liver enzymes, and low platelets data were stratified according to gestational age at onset of HELLP < or =28 weeks and >28 weeks.


RESULTS
Fifty-three patients had subsequent pregnancies with 24% complicated by HELLP and 28% by preeclampsia. During follow-up, 33% of the patients had new onset hypertension develop, 32% had depression develop, 26% had anxiety develop, and 2.4% required dialysis. There was no significant difference in long-term outcome between comparison groups.


CONCLUSIONS
Patients with a history of HELLP are at increased risk for preeclampsia and HELLP as well as long-term morbidities as depression and chronic hypertension. Gestational age at the onset of HELLP could be a predictor for long-term outcome.
Habli
Mounira
M
Department of Obstetrics and Gynecology, Bethesda North Hospital, University of Cincinnati, Cincinnati, OH, USA.
Eftekhari
Nahid
N
Wiebracht
Emily
E
Bombrys
Annette
A
Khabbaz
Maram
M
How
Helen
H
Sibai
Baha
B
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000453:epidemiology*; D006801:Humans; D009035:Mothers / Q000523:psychology; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D011379:Prognosis; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology