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重度子痫前期与HELLP综合征:孕<34周和≥34周时的母婴结局

Severe Preeclampsia versus HELLP Syndrome: Maternal and Perinatal Outcomes at <34 and ≥34 Weeks' Gestation.

作者信息

Kınay Tuğba, Küçük Canan, Kayıkçıoğlu Fulya, Karakaya Jale

机构信息

Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.

Department of Anesthesiology and Reanimation, Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.

出版信息

Balkan Med J. 2015 Oct;32(4):359-63. doi: 10.5152/balkanmedj.2015.15777. Epub 2015 Oct 1.

Abstract

BACKGROUND

Preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP) syndrome are important disorders affecting the health of both the mother and fetus. Prediction of the maternal and perinatal outcomes at early and late gestational age is important for the management of both disorders.

AIMS

The purpose of the study was to investigate adverse maternal and perinatal outcomes in severe preeclampsia and HELLP syndrome cases according to gestational age.

STUDY DESIGN

Retrospective cross-sectional study.

METHODS

One hundred and ninety-seven pregnancies with severe preeclampsia and 56 pregnancies with HELLP syndrome were included the study. Clinical characteristics and adverse maternal and perinatal outcomes were noted from medical records. Participants were divided into two groups at <34 and ≥34 weeks' gestation: the severe preeclampsia group and the HELLP syndrome group. The differences between the outcomes in the groups were investigated. Statistical analysis was performed using the Student t test, Fisher Exact test and Yates' Chi-square test.

RESULTS

Eclampsia was more common in HELLP syndrome cases at <34 weeks' gestation (p 0.028). However, eclampsia rates were statistically similar between groups at ≥34 weeks' gestation. The requirement for blood products transfusion was higher in the HELLP group at all gestational weeks. No statistical difference was found in perinatal outcomes between severe preeclampsia and HELLP groups at less than and more than 34 weeks' gestation.

CONCLUSION

Eclampsia risk increases in HELLP syndrome, especially at gestations less than 34 weeks. Perinatal morbidity at less than 34 weeks' gestation and mortality were similar in severe preeclampsia and HELLP syndrome cases at the same gestational age.

摘要

背景

子痫前期以及溶血、肝酶升高和血小板减少(HELLP)综合征是影响母婴健康的重要疾病。预测孕早期和晚期的孕产妇及围产儿结局对于这两种疾病的管理至关重要。

目的

本研究旨在根据孕周调查重度子痫前期和HELLP综合征病例的不良孕产妇及围产儿结局。

研究设计

回顾性横断面研究。

方法

本研究纳入了197例重度子痫前期妊娠和56例HELLP综合征妊娠。从病历中记录临床特征以及不良孕产妇及围产儿结局。参与者按孕周<34周和≥34周分为两组:重度子痫前期组和HELLP综合征组。研究两组结局之间的差异。采用学生t检验、Fisher精确检验和Yates卡方检验进行统计分析。

结果

孕周<34周的HELLP综合征病例中,子痫更常见(p = 0.028)。然而,孕周≥34周时,两组间子痫发生率在统计学上相似。所有孕周的HELLP组输血需求更高。重度子痫前期组和HELLP组在孕周小于34周和大于34周时,围产儿结局无统计学差异。

结论

HELLP综合征的子痫风险增加,尤其是孕周小于34周时。相同孕周下,重度子痫前期和HELLP综合征病例在孕周小于34周时的围产儿发病率及死亡率相似。

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