Pinning Down HELLP: A Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Preeclampsia and HELLP syndrome, both disorders unique to pregnancy, remain a major cause of maternal and neonatal mortality and morbidity worldwide. It is the most common medical disorder complicating pregnancy. In both of these disorders, the liver is a major target with often devastating consequences. The pathogenesis of hepatic damage in cases of severe preeclampsia and HELLP syndrome is not well understood. Diagnosis of HELLP syndrome is heavily relied upon laboratory investigation. In the management, first priority is to assess and stabilize the maternal condition, particularly coagulation abnormalities followed by evaluation of fetal well‑being and finally, a decision must be made as to whether or not immediate delivery is indicated. Women with a prior history of HELLP syndrome carry an increased risk of at least 20% (range 16%-52%) risk of recurrence of some form of hypertension, so future pregnancy counseling and follow up is essential.Hypertensive disorders of pregnancy are a dreaded disease for both the mother and the fetus. Preeclampsia and HELLP syndrome, both disorders unique to pregnancy, remain a major cause of maternal and neonatal mortality and morbidity worldwide. It is the most common medical disorder complicating pregnancy, affecting 7 to 15% of all women. As high as 22% perinatal deaths and 30% of maternal deaths in developed countries are because of preeclampsia. The situation is far by worse in developing countries because of low antenatal turn up, delayed reporting and inefficient management in most of the heath setups [1]. Credit for formally consolidating the concept and creating the acronym of HELLP (H = hemolysis, EL = elevated liver enzymes and LP = low platelets) goes to Louis Weinstein who in 1982 reported a group of 29 pregnant patients he considered to have a distinct subset of severe preeclampsia/eclampsia. There is considerable disagreement in the medical literature regarding the terminology, incidence, diagnosis, and management of the HELLP syndrome. During the past 15 years, numerous retrospective and observational studies as well as few randomized trials have been published in an attempt to refine the diagnostic criteria for this syndrome, to identify risk factors for adverse pregnancy outcome, and to reduce maternal and perinatal outcomes in women with this syndrome. Despite this recent literature, the diagnosis, management, and pregnancy outcome of HELLP syndrome remain controversial [2].
Authors and Affiliations
Hafizur Rahman
Keywords
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- EP ID EP570548
- DOI 10.26717/BJSTR.2017.01.000267
- Views 179
- Downloads 0
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