Abbade Joelcio Francisco, Peraçoli José Carlos, Costa Roberto Antonio Araújo, Calderon Iracema de Mattos Paranhos, Borges Vera Therezinha Medeiros, Rudge Marilza Vieira Cunha
Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, São Paulo, Brazil.
Sao Paulo Med J. 2002 Nov 1;120(6):180-4. doi: 10.1590/s1516-31802002000600005. Epub 2003 Jan 22.
HELLP syndrome is a severe complication of pregnancy characterized by hemolysis, elevated liver enzymes and low platelet count. Some pregnant women develop just one or two of the characteristics of this syndrome, which is termed Partial HELLP Syndrome (PHS).
The objective of this study was to evaluate the repercussions on maternal and perinatal outcomes among women that developed PHS and to compare these women with those whose gestational hypertension or preeclampsia did not show alterations for HELLP syndrome in laboratory tests.
Observational, retrospective and analytical study.
Maternity Department of Hospital das Cl nicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, S o Paulo, Brazil.
Pregnant or post-delivery women who had a blood pressure elevation that was first detected after mid-pregnancy, with or without proteinuria, between January 1990 and December 1995.
Analysis was made of maternal age, race, parity, hypertension classification, gestational age at the PHS diagnosis, alterations in laboratory tests for HELLP syndrome, time elapsed to discharge from hospital, maternal complications, mode of delivery, incidence of preterm birth, intrauterine growth restriction, stillborn and neonatal death.
Three hundred and eighteen women were selected; forty-one women (12.9%) had PHS and 277 of them (87.1%) did not develop any of the alterations of the HELLP syndrome diagnosis. Preeclampsia was a more frequent type of hypertension in the PHS group than in the hypertension group. None of the women with isolated chronic hypertension developed PHS. The rate of cesarean delivery, eclampsia, and preterm delivery was significantly greater in the PHS group than in the hypertension group.
We observed that aggressive procedures had been adopted for patients with PHS. These resulted in immediate interruption of pregnancy, with elevated cesarean rates and preterm delivery. Such decisions need to be reviewed, in order to reduce the cesarean rate and the incidence of preterm delivery.
HELLP综合征是妊娠期一种严重并发症，其特征为溶血、肝酶升高及血小板计数降低。部分孕妇仅出现该综合征的一两种特征，称为部分性HELLP综合征（PHS）。
本研究旨在评估发生PHS的女性对孕产妇及围产儿结局的影响，并将这些女性与妊娠期高血压或子痫前期但实验室检查未显示HELLP综合征改变的女性进行比较。
观察性、回顾性分析研究。
巴西圣保罗州立大学博图卡图医学院附属医院妇产科。
1990年1月至1995年12月期间妊娠中期后首次检测出血压升高、有或无蛋白尿的孕妇或产后女性。
分析产妇年龄、种族、产次、高血压分类、PHS诊断时的孕周、HELLP综合征实验室检查改变、出院时间、孕产妇并发症、分娩方式、早产发生率、胎儿生长受限、死产及新生儿死亡情况。
共选取318名女性；41名女性（12.9%）患有PHS，其中277名（87.1%）未出现HELLP综合征诊断的任何改变。子痫前期在PHS组中是比高血压组更常见的高血压类型。孤立性慢性高血压女性均未发生PHS。PHS组剖宫产、子痫及早产发生率显著高于高血压组。
我们观察到对PHS患者采取了积极措施。这些措施导致妊娠立即中断，剖宫产率和早产率升高。此类决策需重新审视，以降低剖宫产率和早产发生率。
