title: Preeclampsia and eclampsia incidence in the eastern anatolia region of Turkey: the effects of high altitude.
abstract: OBJECTIVE
  Hypertensive disorders of pregnancy remain a leading cause of maternal and perinatal mortality and morbidity. The purpose of this study was to determine the distribution map related to pregnancy toxicosis of provinces in our region and the effects of altitude on hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and eclampsia.
  
  
  METHODS
  Patients who were admitted to Atatürk University, Obstetrics and Gynecology Department with preeclampsia, eclampsia and a diagnosis of HELLP syndrome for the 5 years between1998-2002 were chosen. The birth rate was obtained from the health directorate of provinces in our area during the same period. Provinces were divided into two groups by altitude: less than and more than 1500 m above sea level.
  
  
  RESULTS
  The rates of HELLP syndrome and eclampsia diagnoses were 1.4 per 10.000 patients living above 1500 m altitude. However, this rate was 0.96 per 10.000 patients living below 1500 m altitude (p < 0.01). The highest rate of eclampsia and HELLP syndrome was seen in the Ardahan province, in 36 patients per 10,000 births, whereas the lowest rate was seen in the Iğdır province, 9.9 patients per 10,000 births.
  
  
  CONCLUSIONS
  Altitude contributes to occurrence of HELLP syndrome and eclampsia. Since the rate of pregnancy related hypertension is higher at high altitude, it is vital that these patients should be diagnosed during the early stages of the diseases in order to decrease complications.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Kumtepe
authors.affiliation: Department of Obstetrics and Gynecology, Trabzon Women's Hospital, Trabzon, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Dündar
authors.affiliation: Department of Obstetrics and Gynecology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Cetinkaya
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Ingeç
keywords: HELLP syndrome; Preeclampsia; eclampsia; high altitude