[HELLP syndrome: a rare, threatening complication in pre-eclampsia].

A very rare, but severe complication, occurring together with preeclampsia, is the so-called HELLP syndrome (H for haemolysis, EL for elevated liver enzymes and LP for low platelet counts). Perinatal mortality for this syndrome is estimated at 9.5% up to 60%, maternal mortality at 3.5%. We examined retrospectively 11 patients of the last 5 years, presenting not only hypertension, proteinuria and oedema, but also pathologically elevated data concerning transaminases, indirect bilirubin and thrombocytopenia; the mean value for GI in this group was 7.7 (3-11). Thrombocyte counts showed mean values of 71,000 +/- 28,500. In 9 cases the patients suffered from severe upper abdominal pain. Liver enzymes and bilirubin were clearly elevated. Time interval between onset of therapy and delivery was 3 days on the average, the mean gestational age at time of delivery was 34 weeks (27-39), average infant weight amounted to 1,960 g (580-3,700 g). 7 of the 11 women delivered by Caesarian section (64%); perinatal, respectively neonatal 3 babies died (27%). In two cases one Caesarian section did not produce maternal complications; 3 women had to undergo a hysterectomy. This syndrome is associated with a very problematic obstetrical situation in respect of differential diagnosis, foetal outcome and the high frequency of postoperative maternal complications.