Clinical Study on Hellp Syndrome- Maternal and Perinatal Outcome

The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. Aim: The objective of the present prospective study is on incidence, diagnosis, and its variable presentations of HELLP syndrome in preeclampsia, eclampsia to analyze the severity and complications, as it is associated with maternal, perinatal morbidity and mortality. HELLP syndrome is difficult to diagnose when it presents with atypical clinical features like high blood pressure and no protienuria, flu like symptoms, malaise, fever, nausea, vomiting, epigastric pain. Methods: In the prospective study of 414 admitted cases with more than 24 weeks of gestation, 324 were preeclampsia while 90 were eclampsia. The selected cases were analyzed clinically with relevant history, clinical data and detailed laboratory investigations the classification is made for better analyses of complications and outcome in HELLP syndrome. RESULTS: Under further clinical diagnosis of 324 cases of preeclampsia, 116 cases (35%) were of HELLP Syndrome and out of 90 cases of eclampsia, 17(18%) cases were HELLP Syndrome. Majority of the cases belonged to 19-28 years age group and were mostly from lower socio-economic conditions. The present study shows 4.5% maternal mortality and perinatal mortality as 35.33%. Conclusion: The diagnosis of HELLP Syndrome has been made as a severe variant and complication of severe preeclampsia and eclampsia. It needs early diagnosis, timely intervention to arrest further progress and complications like multi organ dysfunction, renal failure, DIC, abruption etc and to improve perinatal outcome. Keyword: HELLP Syndrome, perinatal mortality and maternal morbidity