Capellino María F, Galetto Silvia, Sad Larcher José M, Travella Claudia, Ferreyra Mirta, Ruiz Orrico Guillermo
Servicio de Ginecología y Obstetricia, Hospital Privado de Córdoba, Argentina.
Medicina (B Aires). 2003;63(5):383-7.
HELLP syndrome (Hemolysis, Elevated Liver Enzymes and Low Platelets) was described by Weinstein in 1982. It has a high maternal and perinatal morbi-mortality rate. We undertook this study to evaluate perinatal outcome in patients with HELLP syndrome. Patients with HELLP syndrome were identified in a retrospective study between March 1998 and March 2001 at the Hospital Privado de Córdoba. Maternal and neonatal variables were analyzed. Nine patients with HELLP syndrome were identified (incidence 2.3@1000). Mean maternal age was 24.5 (15-36) years. Five patients were nuliparous. The mean gestational age was 34.5 weeks (29-40). The main symptom was epigastric pain (77.7%). In seven women delivery was made by cesarean section. Three patients had postpartum HELLP syndrome. Three patients had difficult control hypertension; one had eclampsia and another one had disseminated intravascular coagulopathy with acute renal failure and died. Three women needed blood products transfusions. The average admission time was 4.4 days. There were six preterm infants (75%). Mean birth weight was 2030 g (736-3200). Four neonates had Apgar score < 7 at the first minute, all had > 7 at 5 minutes. Three neonates had alimentary disorders, one had hypoglucemia and another hyaline membrane disease, patent ductus arteriosus, sepsis and thrombocytopenia. The high maternal and perinatal morbi-mortality of HELLP syndrome requires management in a centre where intensive maternal and neonatal care are available.
HELLP综合征（溶血、肝酶升高和血小板减少）由温斯坦于1982年首次描述。它具有较高的孕产妇和围产期病率及死亡率。我们开展这项研究以评估HELLP综合征患者的围产期结局。在1998年3月至2001年3月期间于科尔多瓦私立医院进行的一项回顾性研究中确定了HELLP综合征患者。对孕产妇和新生儿变量进行了分析。确定了9例HELLP综合征患者（发病率为2.3/1000）。孕产妇平均年龄为24.5（15 - 36）岁。5例为初产妇。平均孕周为34.5周（29 - 40周）。主要症状为上腹部疼痛（77.7%）。7名女性通过剖宫产分娩。3例患者产后出现HELLP综合征。3例患者高血压控制困难；1例发生子痫，另1例发生弥散性血管内凝血伴急性肾衰竭并死亡。3名女性需要输血。平均住院时间为4.4天。有6例早产儿（75%）。平均出生体重为2030克（736 - 3200克）。4例新生儿1分钟时阿氏评分<7分，5分钟时均>7分。3例新生儿有消化系统疾病，1例有低血糖，另1例有透明膜病、动脉导管未闭、败血症和血小板减少症。HELLP综合征较高的孕产妇和围产期病率及死亡率需要在具备强化孕产妇和新生儿护理的中心进行管理。
