Huang Hui, Liu Bo, Gao Xia, Wang Yunju
Department of Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
Front Surg. 2022 Mar 14;9:859180. doi: 10.3389/fsurg.2022.859180. eCollection 2022.
To investigate the clinical classification, pregnancy outcomes and risk factors of pregnant women with severe preeclampsia (SPE) complicated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.
The clinical data of 50 pregnant women diagnosed with SPE complicated with HELLP syndrome in our hospital from January 2014 to January 2021 were retrospectively analyzed, and they were selected as the observation group. An additional 50 maternities diagnosed with preeclampsia (PE) during the same period were selected as the control group. The clinical classification and pregnancy outcomes of pregnant women in the observation group were recorded. The age and gestational age of onset of pregnancy were recorded and compared between the two groups. Univariate analysis and multivariate logistic regression model were used to analyze the risk factors for its occurrence.
Among the 50 maternities in the observation group, there were 10 cases of type I, accounting for 20.00%; 35 cases of type II, accounting for 70.00%; 5 cases of type III, accounting for 10.00%. Partial 33 cases, the composition ratio of 66.00%; complete 17 cases, the composition ratio of 34.00%. Among the fetuses of 50 maternities in the observation group, 35 were premature, accounting for 70.00%; 13 had fetal growth restriction, accounting for 26.00%; and 2 died during perinatal period, accounting for 4.00%. Among the 50 maternities in the observation group, 48 cases were cesarean section, the composition ratio was 96.00%; 2 cases were induced labor, the composition ratio was 4.00%; there was no natural birth, the composition ratio was 0.00%. Univariate analysis showed that age, gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, PT, and FIB were all associated with the occurrence of SPE complicated with HELLP syndrome ( < 0.05). Multivariate logistic analysis showed that gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, and FIB were independent risk factors for SPE complicated with HELLP syndrome ( < 0.05).
SPE complicated with HELLP syndrome has significantly increased adverse pregnancy outcomes. Understanding its clinical classification is of great significance for the preventive application of platelet transfusion therapy and the selection of transfusion timing. Gestational age at onset and gestational age at termination of pregnancy are independent risk factors for its occurrence. Fully understanding the high-risk factors of HELLP syndrome, taking preventive measures in time, and carrying out targeted nursing can effectively improve the prognosis of pregnant women and reduce the risk of HELLP syndrome.
探讨重度子痫前期(SPE)合并HELLP(溶血、肝酶升高和血小板减少)综合征孕妇的临床分类、妊娠结局及危险因素。
回顾性分析2014年1月至2021年1月在我院诊断为SPE合并HELLP综合征的50例孕妇的临床资料,将其作为观察组。另选取同期诊断为子痫前期(PE)的50例产妇作为对照组。记录观察组孕妇的临床分类及妊娠结局。记录并比较两组孕妇的年龄及发病孕周。采用单因素分析和多因素logistic回归模型分析其发生的危险因素。
观察组50例产妇中,Ⅰ型10例,占20.00%;Ⅱ型35例,占70.00%;Ⅲ型5例,占10.00%。部分性33例,构成比66.00%;完全性17例,构成比34.00%。观察组50例产妇的胎儿中,早产35例,占70.00%;胎儿生长受限13例,占26.00%;围生期死亡2例,占4.00%。观察组50例产妇中,剖宫产48例,构成比96.00%;引产2例,构成比4.00%;无自然分娩,构成比0.00%。单因素分析显示,年龄、发病孕周、终止妊娠孕周、血红蛋白(HGB)、乳酸脱氢酶(LDH)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、血小板(PLT)、凝血酶原时间(PT)及纤维蛋白原(FIB)均与SPE合并HELLP综合征的发生有关(P<0.05)。多因素logistic分析显示,发病孕周、终止妊娠孕周、HGB、LDH、ALT、AST、TBIL、PLT及FIB是SPE合并HELLP综合征的独立危险因素(P<0.05)。
SPE合并HELLP综合征的不良妊娠结局显著增加。了解其临床分类对预防性应用血小板输注治疗及选择输血时机具有重要意义。发病孕周和终止妊娠孕周是其发生的独立危险因素。充分认识HELLP综合征的高危因素,及时采取预防措施并实施针对性护理,可有效改善孕妇预后,降低HELLP综合征的发生风险。