Zuberi N F, Arif K, Khan F M, Pal J A
Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 1998 Feb;48(2):29-32.
The relationship of Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome with maternal and perinatal health and its presentation in Pakistani population is not known.
To determine the mode of presentation along with maternal and perinatal outcome of patients with HELLP syndrome.
Case records of patients with severe hypertension in pregnancy who delivered between January 1, 1989 and December 31, 1994 at The Aga Khan University Hospital, Karachi. Out of 120 cases of severe pre-eclampsia/eclampsia, there were 36 cases of HELLP syndrome (Group-A). These were then compared with cases without HELLP syndrome (Group B) for their mode of presentation along with maternal and perinatal morbidity and mortality.
The overall incidence of HELLP syndrome was 0.4%. In the antepartum factors; unbooked status (66% vs 30%; p < 0.05), diastolic B.P. > 120 mmHg (61% vs 16%; p < 0.05) DIC (13% vs 2%; p = 0.03), seizures (40% vs 16%, p = 0.01) and ARF (11% vs 1%, p = 0.07) were significantly raised. In the intrapartum factors there were no significant differences between the two groups in mode of delivery and complications of delivery. Neonatal outcomes did not differ significantly in the two groups.
Women with severe hypertension in pregnancy manifesting with HELLP syndrome show a significantly greater frequency of developing DIC, seizures and acute renal failure. Therefore, their care necessitates intensive monitoring to preclude development of these complications.
溶血、肝酶升高和血小板减少（HELLP）综合征与孕产妇及围产期健康的关系以及其在巴基斯坦人群中的表现尚不清楚。
确定HELLP综合征患者的临床表现方式以及孕产妇和围产期结局。
收集1989年1月1日至1994年12月31日在卡拉奇阿迦汗大学医院分娩的重度妊娠期高血压患者的病例记录。在120例重度子痫前期/子痫病例中，有36例为HELLP综合征（A组）。然后将这些病例与无HELLP综合征的病例（B组）在临床表现方式、孕产妇和围产期发病率及死亡率方面进行比较。
HELLP综合征的总体发病率为0.4%。在产前因素方面；未登记状态（66%对30%；p<0.05）、舒张压>120 mmHg（61%对 16%；p<0.05）、弥散性血管内凝血（DIC，13%对2%；p = 0.03）、癫痫发作（40%对16%，p = 0.01）和急性肾衰竭（ARF，11%对1%，p = 0.07）显著升高。在产时因素方面，两组在分娩方式和分娩并发症方面无显著差异。两组的新生儿结局无显著差异。
患有重度妊娠期高血压并表现为HELLP综合征的女性发生DIC、癫痫发作和急性肾衰竭的频率显著更高。因此，对她们的护理需要加强监测以预防这些并发症的发生。
