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2012, Número 4

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Rev Hematol Mex 2012; 13 (4)


Síndrome de HELLP, diagnóstico y tratamiento

Gutíerrez-Aguirre CH, Alatorre-Ricardo J, Cantú-Rodríguez O, Gómez-Almaguer D

Idioma: Español
Referencias bibliográficas: 30
Paginas: 195-200
Archivo PDF: 176.32 Kb.


RESUMEN

El síndrome de HELLP es una complicación sistémica del embarazo de etiología desconocida que afecta al 0.9% de todos los embarazos y se relaciona con elevada morbilidad y mortalidad materna y fetal. Se caracteriza por anemia hemolítica microangiopática, elevación de las enzimas hepáticas y trombocitopenia por consumo. Aparece, sobre todo, en el tercer trimestre del embarazo con afectación a órganos blanco como: hígado, riñones y sangre y, aunque el tratamiento definitivo es la interrupción del embarazo, es necesario recurrir a otras medidas terapéuticas con el propósito de disminuir las complicaciones maternas y fetales de esta enfermedad. El pronóstico final dependerá, en parte, de la rapidez con que se establezca el diagnóstico y se inicie el tratamiento.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol 1993; 169:1000- 1006.

  2. Kjell Haram, Einar Svendsen, Ulrich Abildgaard. The HELLP syndrome: Clinical issues and management. A review. BMC Pregnancy and Childbirth 2009;9:8.

  3. Dan Mihu, Nicolae Costin, Carmen Mihaela Mihu, Andrada Seicean, Rãzvan Ciortea. HELLP Syndrome-a Multisystemic Disorder. J Gastrointestin Liver Dis December 2007;16(4):419-424.

  4. Weinstein L. Syndrome of hemolyis, elevated liver enzymes, low platelet count: a severe consequence of hypertension on pregnancy. American Journal of Obstetrics and Gynecology 1982;142:159-167.

  5. Ertan AK, Wagner S, Hendrik HJ, Tanriverdi HA, Schmidt W. Clinical and biophysical aspects of HELLP-syndrome. J Perinat Med 2002;30:483-489.

  6. Gul A, Cebeci A, Aslan H, Polat I, Ozdemir A, Ceylan Y. Perinatal outcomes in severe preeclampsia-eclampsia with and without HELLP syndrome. Gynecol Obstet Invest 2005; 59:113-118.

  7. Calvin Pan, Ponni VP. Pregnancy-Related Liver Diseases. Clin Liver Dis 2011;15:199-208.

  8. Lyall F, Greer JA. Preeclampsia: a multifaceted vascular disorder of pregnancy. Journal of Hypertension1994;12:1339-1345.

  9. Mushambi MC, Halligan AW, Williamson K. Recent developments in the pathophysiology and management of preeclampsia. British Journal of Anaesthesia 1996; 76:133-148.

  10. Agatisa PK, Ness RB, Roberts JM, Costantino JP, Kuller LH, McLaughlin MK. Impairment of endothelial function in women with a history of preeclampsia: an indicator of cardiovascular risk. Am J Physiol Heart Circ Physiol 2004;286:1389-1393.

  11. Goldman-Whol D, Yagel S. Regulation of trophoblast invasion: from normal implantation to pre-eclampsia. Mol Cell Endocrinol 2002;187:233-238.

  12. Kaufmann PS, Black BH. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod 2003;69:1-7.

  13. Martin JN, Rose CH, Briery CM. Understanding and managing HELLP syndrome: the integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol 2006;195:914-934.

  14. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol 2004;103:981-991.

  15. Wilke G, Rath W, Schutz E, Armstrong VW, Kuhn W. Haptoglobin as a sensitive marker of hemolysis in HELLP-syndrome. Int JGynaecol Obstet 1992;39:29-34.

  16. McCrae KR, Samuels P, Schreiber AD. Pregnancy-associated thrombocytopenia: pathogenesis and management. Blood 1992;80(11):2697-2714.

  17. Young B, Levine R, Salahuddin S, Qian C. The use of angiogenic biomarkers to differentiate non-HELLP related thrombocytopenia from HELLP syndrome. J Matern Fetal Neonatal Med 2010; 23(5):366-370.

  18. O’Hara M. HELLP Syndrome: Recognition and Perinatal Management. Am Fam Physician 1999;60(3):829-836.

  19. Chiara B, Marozio L, Annalisa T, Picardo E, et al. Biochemestry of HELLP Syndrome. Advances in Clinical Chemestry. Vol. 53.

  20. Martin JN, Files JC, Blake PG, Norman PH, Martin RW, et al. Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome. Am J Obstet Gynecol 1990;162(1):126-137.

  21. Sibai BM. Imitators of severe pre-eclampsia/eclampsia. Clin- Perinatol 2004;31:835-852.

  22. Thomas T, Jophy R, Mhaskar A, Misguith D. Are we increasing serious maternal morbidity by postponing termination of pregnancy in severe pre-eclampsia/eclampsia? J Obstet Gynaecol 2005;25:347-351.

  23. Lee NM, Brady CW. Liver disease in pregnancy. World J Gastroenterol 2009;15(8): 897-906.

  24. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T. Corticosteroids for HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in pregnancy. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD008148

  25. Vidaeff AC, Yeomans ER. Corticosteroids for the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): what evidence? Minerva Ginecol 2007;59:183-190.

  26. Jobe AH, Soll RF. Choice and dose of corticosteroid for antenatal treatments. Am J Obstet Gynecol 2004;190:878-881.

  27. Bayraktaroqlu Z, Demirci F, Balat O, Kutlar I, Okan V, Uður G. Plasma exchange therapy in HELLP syndrome: A single-center experience. Turk J Gastroenterol 2006;17: 99-102.

  28. Harris BM, Kuczkowski KM. Diagnostic dilemma: hepatic rupture due to HELLP syndrome vs trauma. Arch Gynecol Obstet 2005;272:176-178.

  29. Suzuki T, Kaneda T. Anesthesia in three women with HELLP syndrome. Masui 2007; 56:838-841.

  30. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol 1993;169:1000-1006.




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