Celik Cetin, Gezginç Kazim, Altintepe Lutfullah, Tonbul H Zeki, Yaman S Tülin, Akyürek Cemalettin, Türk Süleyman
Selçuk University Faculty of Meram Medicine, Department of Obstetrics and Gynecology-Nephrology, Konya, Turkey.
Ren Fail. 2003 Jul;25(4):613-8. doi: 10.1081/jdi-120022553.
In this study, clinical features, developing complications, and results of thirty-six patients, which were followed up in our Obstetrics and Gynecology and Nephrology departments between 1997 and 2001, with the diagnosis of HELLP syndrome were searched retrospectively. The mean age of the cases followed up with diagnosis of HELLP syndrome were 30.2 +/- 5.9 (17-46) years. HELLP syndrome was diagnosed on average in the 32.6 +/- 4.8th (23-41) week of gestations. Seventy percent of the cases were with severe preeclampsia and 30% of the cases were with mild preeclampsia. Eleven cases (30%) were nullipara and twenty-five cases (70%) multipara. The average of arterial systolic blood pressure of the cases were 161.6 +/- 26 mmHg, and that of diastolic blood pressure was 98.5 +/- 16.8 mmHg. In thirteen cases (36%) acute renal failure (ARF), six cases (17%) placenta detachment, two cases disseminate intravascular coagulation (DIC), one case Adult Respiratory Distress Syndrome (ARDS) were developed. In seven cases (19%) intrauterine dead fetuses were detected. In twenty-three cases by cesarian section (64%), in thirteen cases by induction (36%) the pregnancies were terminated in 72 h after diagnosing HELLP syndrome. Birth weights of eleven babies (30%) were below 1500 g. Five of the eleven babies were dead in the neonatal period. Six of the thirteen patients who had ARF were given hemodialysis. Two patients died because of the development of ARF + DIC and ARDS. No predicting factors for the development of HELLP syndrome could be detected, but severe preeclampsia. Therefore we think that preeclamptic pregnancies must be followed up very closely and if HELLP syndrome develops, termination of the pregnancy would be proper as soon as possible.
本研究对1997年至2001年间在我院妇产科和肾内科随访的36例诊断为HELLP综合征的患者的临床特征、并发症发生情况及结果进行了回顾性分析。随访诊断为HELLP综合征的患者平均年龄为30.2±5.9（17 - 46）岁。HELLP综合征平均在妊娠32.6±4.8（23 - 41）周时被诊断。70%的病例为重度子痫前期，30%的病例为轻度子痫前期。11例（30%）为初产妇，25例（70%）为经产妇。患者动脉收缩压平均为161.6±26 mmHg，舒张压平均为98.5±16.8 mmHg。13例（36%）发生急性肾衰竭（ARF），6例（17%）发生胎盘早剥，2例发生弥散性血管内凝血（DIC），1例发生成人呼吸窘迫综合征（ARDS）。7例（19%）检测到宫内死胎。23例（64%）通过剖宫产、13例（36%）通过引产在诊断HELLP综合征后72小时内终止妊娠。11例婴儿（30%）出生体重低于1500 g。11例婴儿中有5例在新生儿期死亡。13例发生ARF的患者中有6例接受了血液透析。2例患者因发生ARF + DIC和ARDS死亡。除重度子痫前期外，未发现HELLP综合征发生的预测因素。因此，我们认为子痫前期妊娠必须密切随访，一旦发生HELLP综合征，应尽快终止妊娠。
