title: Incidence of eclampsia with HELLP syndrome and associated mortality in Latin America.
abstract: OBJECTIVE
  To describe the maternal outcome among women with eclampsia with and without HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count).
  
  
  METHODS
  A cross-sectional study of women with eclampsia was undertaken in 14 maternity units in Latin America between January 1 and December 31, 2012. Outcomes were compared between women with and without concomitant HELLP syndrome. Logistic regression analysis was performed to identify independent risk factors of maternal mortality.
  
  
  RESULTS
  There were 196 eclampsia cases among 115 038 deliveries; 142 (72.4%) women had eclampsia alone and 54 (27.6%) women had concomitant HELLP syndrome. Severe systolic hypertension (≥160 mm Hg), severe diastolic hypertension (≥110 mm Hg), and hypertensive encephalopathy were significantly more common among women with HELLP than among those with eclampsia alone (P=0.01 for all). There were 8 (4.1%) maternal deaths, all in the group with HELLP syndrome, and 18 (9.1%) perinatal deaths. In a multivariate regression model, maternal mortality was significantly associated with low platelet count and severe systolic hypertension (P<0.05).
  
  
  CONCLUSIONS
  Eclampsia with HELLP syndrome is a dangerous complication associated with pregnancy. Low platelet count secondary to HELLP syndrome and severe systolic hypertension were independently associated with maternal mortality from eclampsia.
authors: Critical Care Unit, Department of Obstetrics and Gynecology, Complejo Hospitalario de la Caja de Seguro Social, Panama City, Panama. Electronic address: pvigild@hotmail.com.
authors: Paulino
authors: P
authors: Vigil-De Gracia
authors: Critical Care Unit, Clínica de Maternidad Rafael Calvo, Cartagena, Colombia.
authors: José
authors: J
authors: Rojas-Suarez
authors: Department of Gynecology and Obstetrics, Hospital Universitario Dr Luis Razetti, Barcelona, Venezuela.
authors: Edwin
authors: E
authors: Ramos
authors: Unit of Research, Department of Gynecology and Obstetrics, Hospital Santo Tomás, Panama City, Panama.
authors: Osvaldo
authors: O
authors: Reyes
authors: Department of Gynecology and Obstetrics, Hospital Regional de Cojamarca, Cajamarca, Peru.
authors: Jorge
authors: J
authors: Collantes
authors: Department of Gynecology and Obstetrics, Hospital José Domingo de Obaldía, David, Panama.
authors: Arelys
authors: A
authors: Quintero
authors: Unit of Perinatology, Department of Gynecology and Obstetrics, Instituto Nacional Materno Perinatal, Lima, Peru.
authors: Erasmo
authors: E
authors: Huertas
authors: Department of Gynecology and Obstetrics, Hospital Carlos Andrade Marín, Quito, Ecuador.
authors: Andrés
authors: A
authors: Calle
authors: Unit of Research, Department of Gynecology and Obstetrics, Hospital Primero de Mayo de Seguridad Social, San Salvador, El Salvador.
authors: Eduardo
authors: E
authors: Turcios
authors: Department of Gynecology and Obstetrics, Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador.
authors: Vicente Y
authors: VY
authors: Chon
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004461:Eclampsia / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D020343:Hypertensive Encephalopathy / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D008428:Maternal Mortality; D054238:Perinatal Mortality; D010976:Platelet Count; D011247:Pregnancy; D055815:Young Adult
keywords: Eclampsia; HELLP syndrome; Hypertensive encephalopathy; Latin America; Maternal mortality