Dugatova M, Kristufkova A, Nemethova B, Danis J, Borovsky M
Bratisl Lek Listy. 2018;119(12):785-789. doi: 10.4149/BLL_2018_143.
Hemolysis, Elevated Liver Enzymes, Low Platelets syndrome (HELLP syndrome) is one of the actively haunted maternal morbidity through Slovak Obstetric Survey System (SOSS), the organisation for surveillance of severe maternal morbidity and mortality in Slovakia.
The questionaires were sent in 55 Obstetric Units in Slovakia. The analyzed and here presented data had been collected cases those happened in the period from 1.1.2012 till 31.12.2014. Controls were women from SR during observed years, who delivered without HELLP syndrome.
The return rate of questionnaires was 89.67 %, thus covering 146 972 deliveries during the study period in Slovakia. The exact incidence of HELLP syndrome was 0.63/1000 deliveries (CI 95 % 0.51-0.78). Risk factors were age > 30 (OR = 1.63), nuliparous (OR = 2.96), pregnancy after assisted reproduction technology (OR = 8.29) and multiple pregnancy OR = 9.19). The mean gestation age at delivery was 33.8th weeks. Vaginal delivery was by 10 (10.8 %) patients with HELLP syndrome and in the 83 (89.2 %) patients pregnancy was terminated with acute caesarean section. There were reported 45 050 cases (30.7 %) of the caesarean section in the control group throughout the study period.
The older age, nulliparity, multiple pregnancy and pregnancy after assisted reproduction techniques was identified as a significant risk factors of HELLP syndrome (Tab. 5, Fig. 1, Ref. 21).
溶血、肝酶升高、血小板减少综合征（HELLP综合征）是斯洛伐克产科调查系统（SOSS）中严重困扰产妇发病的疾病之一，该系统是斯洛伐克监测严重孕产妇发病和死亡情况的组织。
向斯洛伐克的55个产科单位发送了调查问卷。分析并在此呈现的数据是2012年1月1日至2014年12月31日期间收集的病例。对照组为观察年份中斯洛伐克共和国未患HELLP综合征的产妇。
问卷回收率为89.67%，因此涵盖了斯洛伐克研究期间的146972例分娩。HELLP综合征的确切发病率为0.63/1000例分娩（95%置信区间0.51 - 0.78）。危险因素包括年龄>30岁（比值比=1.63）、未生育（比值比=2.96）、辅助生殖技术后妊娠（比值比=8.29）和多胎妊娠（比值比=9.19）。分娩时的平均孕周为33.8周。10例（10.8%）患HELLP综合征的患者经阴道分娩，83例（89.2%）患者因急症剖宫产终止妊娠。在整个研究期间，对照组报告有45050例（30.7%）剖宫产病例。
年龄较大、未生育、多胎妊娠以及辅助生殖技术后妊娠被确定为HELLP综合征的重要危险因素（表5，图1，参考文献21）。
