Visser W, Wallenburg H C
Department of Obstetrics and Gynaecology, Erasmus University School of Medicine and Health Sciences, Rotterdam, The Netherlands.
Br J Obstet Gynaecol. 1995 Feb;102(2):111-7. doi: 10.1111/j.1471-0528.1995.tb09062.x.
To test the null hypothesis that the course and outcome of pregnancy in patients with severe pre-eclampsia receiving temporising haemodynamic treatment does not depend on the presence or absence of the syndrome of haemolysis, elevated liver enzymes, and a low platelet count (HELLP).
A case-controlled study.
High risk obstetric unit, University Hospital Rotterdam-Dijkzigt, Rotterdam.
One hundred and twenty-eight consecutive pre-eclamptic patients with HELLP, gestational age less than 34 weeks, matched for maternal and gestational age with 128 pre-eclamptic patients without HELLP.
Both groups were treated with volume expansion and pharmacologic vasodilatation under invasive haemodynamic monitoring with the aim of prolonging gestation and enhancing fetal maturity.
Maternal and perinatal outcome in patients with and without HELLP.
Except for variables pertaining to HELLP, clinical and laboratory data and median prolongation of pregnancy did not differ between both groups. Complete reversal of HELLP occurred in 43% of patients. Perinatal mortality was 14.1% in HELLP patients and 14.8% in patients without HELLP. No maternal complications occurred.
We cannot reject the null hypothesis. Our data do not support a general recommendation of prompt termination of pregnancy in HELLP. Temporising treatment may improve fetal and neonatal as well as maternal outcome.
检验零假设，即接受临时性血液动力学治疗的重度子痫前期患者的妊娠过程及结局不取决于溶血、肝酶升高和血小板减少综合征（HELLP）的有无。
病例对照研究。
鹿特丹大学医院 - 迪克斯希特分院高危产科病房，鹿特丹。
128例连续入选的孕周小于34周的子痫前期HELLP患者，按产妇年龄和孕周与128例无HELLP的子痫前期患者匹配。
两组均在有创血液动力学监测下进行扩容和药物性血管扩张治疗，目的是延长孕周并促进胎儿成熟。
有和无HELLP患者的孕产妇及围产儿结局。
除与HELLP相关的变量外，两组的临床和实验室数据以及妊娠中位数延长情况无差异。43%的患者HELLP完全逆转。HELLP患者的围产儿死亡率为14.1%，无HELLP患者为14.8%。未发生孕产妇并发症。
我们不能拒绝零假设。我们的数据不支持对HELLP患者立即终止妊娠的普遍建议。临时性治疗可能改善胎儿、新生儿及孕产妇结局。
