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Clinical and Experimental Obstetrics & Gynecology  2016, Vol. 43 Issue (6): 795-799    DOI: 10.12891/ceog3012.2016
Original Research Previous articles | Next articles
HELLP syndrome is still a serious, life-threatening complication of pregnancy: admission of 34 women to an eastern Turkish intensive care unit
Z. Bedir1, A. Ahiskalioglu1, *(), Ü. Esenkaya2, E. O. Ahiskalioglu3, A. Dostbil1, M. Aksoy1, N. Dogan1, H. Kursad1
1Ataturk University School of Medicine, Department of Anesthesiology and Reanimation, Erzurum
2Konya Beysehir State Hospital, Department of Obstetric and Gynecology, Konya
3Erzurum Regional and Training Hospital, Department of Anesthesiology and Reanimation, Erzurum (Turkey)
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Abstract  
Objective: The transfer of the obstetric patient to the intensive care unit is considered as an indicator of maternal morbidity. The most important two indications for admittance of the obstetric patient to the intensive care unit are postpartum hemorrhage and hypertensive disorders. The purpose of this study was to determine maternal morbidity and mortality rates in patients diagnosed with hemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome who required intensive care. Materials and Methods: The charts of 34 patients who were diagnosed with HELLP syndrome and treated in intensive care unit between the years 2005 - 2013 were evaluated retrospectively. Results: During the study period, a total of 151 patients were diagnosed with HELLP syndrome and 34 patients were admitted to the intensive care unit. Mean age of the patients was 28.97 ± 7.26 years and there was no significant difference between survivors and non-survivors (p = 0.442). There were no significant differences between survivors and non-survivors in terms of gestational age, parity, and multiparity rates (p > 0.05). There was 31.2% mortal cases and 77.8% of living cases had received regularantenatal follow-up and the difference was statistically significant (p = 0.006). 30 patients (88.2%) required invasive mechanical ventilation. The average Glasgow Coma Score (GCS) of patients was 6.47 ± 4.34. There were significant differences between patients who lived and who died in terms of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) score, and duration of invasive mechanical ventilation (p < 0.05). Twenty-two patients (64.7%) required transfusion of blood and blood products. Maternal mortality occurred in 16 patients (47%). The causes of death were: intracerebral hemorrhage in six cases, acute respiratory distress syndrome (ARDS) in three cases, disseminated intravascular coagulation (DIC) in three cases, sepsis/multiple organ dysfunction syndrome (MODS) in two cases, hepatic rupture in one case, and massive pulmonary embolism in one case. Conclusion: HELLP syndrome is still one of the most serious and life-threatening complications of pregnancy. Mortality rate can be reduced by regular antenatal follow-up and transfer of pregnant women who carry risk to the intensive care unit without delay.
Key words:  HELLP syndrome      Maternal mortality      Intensive care unit     
Published:  10 December 2016     
*Corresponding Author(s):  A. AHISKALIOGLU     E-mail:  aliahiskalioglu@hotmail.com

Cite this article: 

Z. Bedir, A. Ahiskalioglu, Ü. Esenkaya, E. O. Ahiskalioglu, A. Dostbil, M. Aksoy, N. Dogan, H. Kursad. HELLP syndrome is still a serious, life-threatening complication of pregnancy: admission of 34 women to an eastern Turkish intensive care unit. Clinical and Experimental Obstetrics & Gynecology, 2016, 43(6): 795-799.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog3012.2016     OR     https://ceog.imrpress.com/EN/Y2016/V43/I6/795

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