title: HELLP syndrome: 8 years of experience from a tertiary referral center in western Turkey.
abstract: OBJECTIVE
  This study was performed to determine the incidence, symptomatology, complications, mode of delivery, treatment modalities, and risk factors for maternal outcome and perinatal outcome in women with HELLP syndrome.
  
  
  METHODS
  A total of 303 pregnancies with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome diagnosed antenatally were reviewed between 2002 and 2009. Demographic data, including age, parity, gestational age, and clinical and laboratory findings, were recorded from the medical files. In addition, delivery route, indication of cesarean section, and fetal and maternal complications were determined.
  
  
  RESULTS
  Acute renal failure (20.5%) was the most common complication. Eclampsia was present in 303 women with HELLP syndrome (52%). There were four maternal deaths (1.4%). The perinatal mortality rate was 20.3%. The percentages of intracerebral hemorrhage and maternal death were higher in women with eclampsia than in those without (6.3% vs. 0.8%, p = 0.01 and 4.8% vs. 0.4%, p = 0.02, respectively). A nadir platelet count of ≤50,000 cells/mm(3), a peak serum AST of >150 IU/L, and a peak serum LDH of ≥1400 IU/L were not independent risk factors of an adverse outcome.
  
  
  CONCLUSIONS
  We concluded that the incidence rates of serious maternal and fetal morbidities and mortalities are increased in HELLP syndrome. Laboratory parameters of HELLP syndrome are not independent risk factors for adverse neonatal-maternal outcome. Adequate and prompt diagnosis and management are crucial in patients with HELLP syndrome.
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul Bakirkoy Women and Children Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yildirim
authors.forename: Kemal
authors.initials: K
authors.lastname: Gungorduk
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gul
authors.forename: Osman
authors.initials: O
authors.lastname: Asıcıoglu
authors.forename: Sinem
authors.initials: S
authors.lastname: Sudolmus
authors.forename: Ozgu Celikkol
authors.initials: OC
authors.lastname: Gungorduk
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Ceylan
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D008428:Maternal Mortality; D054238:Perinatal Mortality; D011247:Pregnancy; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult