[Subsequent pregnancy outcome in women with a history of preeclampsia and/or HELLP syndrome].

OBJECTIVES

The purpose of this study was to describe outcome of subsequent pregnancy after preeclampsia or HELLP syndrome during the first pregnancy and to evaluate potential risk factors for gestational vascular complications.

PATIENTS AND METHODS

Follow-up data were obtained from 445 women who were delivered between March 1996 and December 2006. Medical records of the index pregnancy and subsequent outcomes were available for review. To have adequate time to study subsequent pregnancy outcome, only patients who were delivered >2 years before the analysis were included.

RESULTS

There were 151 subsequent pregnancies of which 142 pregnancies progressed beyond 20 weeks of gestation. The median duration of follow-up was 6 years (range: 2-9 years). Thirty-nine (27.5%) had a gestational vascular complication. Preeclampsia reoccurred in the second pregnancy in 20 women (51.3%), HELLP syndrome developed in three of these pregnancies. Gestational hypertension occurred in 14 patients (35.9%) and abruptio placentae in one (2.6%). Four of the newborn infants (10.3%) were small for gestational age (<3(rd) percentile). Obesity, delivery<32 weeks of gestation and small for gestational age newborns at index pregnancy were related to a higher incidence of gestational vascular complication during the subsequent pregnancy.

DISCUSSION AND CONCLUSION

Patients with a history of preeclampsia or HELLP syndrome during the index pregnancy are at increased risk for obstetric complications in subsequent pregnancies.