medigraphic.com
ISSN 1025-0255 (Electronic)

2014, Number 5

<< Back Next >>

AMC 2014; 18 (5)

HELLP syndrome in a multipurpose intensive care unit

Jiménez FY, Roura CJO, Caveda EOG, Arévalo TCE

Language: Spanish
References: 27
Page: 475-485
PDF size: 388.80 Kb.


ABSTRACT

Background: HELLP syndrome is a non-rare, infrequent disease, common in obstetric patients with hypertensive vascular disorder of pregnancy; it is the critical expression of this pathological process and its appearance in the multipurpose intensive care unit constitute a challenge because of its possible fatal evolution.
Objective: to characterize the clinical behaviour of the HELLP syndrome in the multipurpose intensive care unit.
Method: a retrospective study of the pregnant women hospitalized in the multipurpose intensive care unit of the Manuel Ascunce Domenech Teaching Hospital, in a period of two years, with the diagnosis of HELLP syndrome, was conducted. Qualitative and quantitative variables were taken into consideration; the frequency distribution of each variable was obtained and the gotten results were emptied out in a form designed for this purpose; the results were provided in a table of percentage values.
Results: the predominant age group was 30 years old and older, mainly with the obstetric condition of being expectant mothers. Elderly and multigravid pregnant women predominated. The preeclampsia-eclampsia syndrome was the most frequent clinical form as complication. Pregnant women presented more complications than puerperas. The most important symptom was epigastric pain. Thrombopenia, from slight to moderate, and the slight elevation of aminotransferases, were the most significant aspects. Lethality in the group was of 16, 67 %.
Conclusions: elderly and multigravid pregnant woman was the most frequent morbid condition for the appearance of HELLP syndrome. The preeclampsia-eclampsia syndrome was the most frequent clinical presentation and the main symptom was epigastralgia.


REFERENCES

  1. Briones GJC, Díaz de León PM. Propuesta urgente. Rev Asoc Mex Med Crit y Ter Int. 2009;23(2):62-3.

  2. Estrada Altamirano A, Hernández Pacheco JA, Vila Herrera S. Síndrome de HELLP, reporte de 52 casos en una unidad de cuidados intensivos. Rev Aso Mex Med Crít Ter Int. Jul-Ago 2003;17(4):34-9.

  3. Briones GJC, Díaz de León PM. Mortalidad materna. En: Briones GJC, Reyes FA, editores. Preeclampsia. México: Editorial Alfil SA de CV.; 2009. p. 1-3.

  4. Martínez Félix JI, Aguirre Ávalos G, Coronado Magaña H. Rev Aso Mex Med Crít Ter Int. Jul-Ago 2001;XV(4):25-32.

  5. Díaz de León PM, Briones GJC. Mortalidad materna. En: Briones GJC, Díaz de León PM, editores. Preeclampsia- Eclampsia. México: Distribuidora y Editora Mexicana SA de CV.; 2010. p. 21-4.

  6. Dildy G. Preeclampsia/Eclampsia. En: Pearlman M, Tintinalli J, editores. Emergency Care of the woman. E.E.U.U.: McGraw-Hill; 1998. p. 59-67.

  7. Aali BS, Nejad SS. Nifedipine or hydralazine as a first-line agentto control hypertension in severe preeclampsia. Acta Obstet Gynecol Scand. 2002;81:25-30.

  8. Barton JR, Hiett AK, Conover WB. The use of nifedipine during the postpartum period in patients with severe preeclampsia. Am J Obstet Gynecol. 1990 Mar;162(3):788-92.

  9. Belfort MA, Anthony J, Kirshon B. Respiratory function in severe gestational proteinuric hypertension: the effects of rapid volume expansion and subsequent vasodilation with verapamil. Br J Obstet Gynaecol. 1991;98:964-72.

  10. Bolte AC, Van Geijn HP, Dekker GA. Management and monitoring of severe preeclampsia (Review). Eur J Obstet Gynecol Reprod Biol.2001 May;96(1):8-20.

  11. Chames MC, Livingston JC, Ivester T. Late postpartum eclampsia: a preventable disease? AM J Obstet Gynecol. 2002 Jun;186(6):1174-7.

  12. Diagnosis and management of preeclampsia and eclampsia. ACOG Practice Bulletin. Obstet Gynecol. 2002 Jan;99(1):159-67.

  13. Katz VL, Farmer R, Kuller JA. Preeclampsia into eclampsia: toward a new paradigm. Am J Obstet Gynecol. 2000 Jun;182(6):1389-96.

  14. MacKay AP, Berg CJ, Atrash HI. Pregnancy related mortality from preeclampsia and eclampsia. Obstet Gynecol. 2001 Apr;97(4):533-8.

  15. Magee L, Sadeghi S. Prevention and treatment of postpartum hypertension. Cochrane Database Syst Rev. 2005;1:CD004351.

  16. Magee LA, Cham C, Waterman EJ, Ohlsson A, Von Dadelszen P. Hydralazine for treatment of severe hypertension in pregnancy: meta analysis. BMJ. 2003 Oct 25;327(7421):955-60.

  17. Magee LA, Miremadi S, Li J, Cheng C. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with preeclampsia. Am J Obstet Gynecol. 2005 Jul;193(1):153-63

  18. Magee LA, von Dadelszen P. The management of severe hypertension. Semin Perinatol. 2009 Jun;33(3):138-42.

  19. O’Brien JM, Shumate SA, Satchwell SL. Maternal benefit of corticosteroids therapy in patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: impact on the rate of regional anesthesia. Am J Obstet Gynecol. 2002;186:475-9.

  20. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000 Jul;183(1):S1-S22.

  21. Scardo JA, Vermillion ST, Newman RB. A randomized, double-blind, hemodynamic evaluation of nifedipine and labetalol in preeclamptic hypertensive emergencies. Am J Obstet Gynecol. 1999 Oct;181(4):862-6.

  22. Sibai BM, Barton JR. Expectant management of severe preeclampsia remote from term: patient selection, treatment, and delivery indications. Am J Obstet Gynecol. 2007 Jun;196(6):514.e1-9.

  23. Dear J, Janga D. Peripartum cardiomyopathy (PPCM) - A rare presentation with abnormal liver function mimicking HELLP syndrome. Arch Dis Child Fetal Neonatal Ed. 2014 Jun;99 Suppl 1:A136.

  24. Haram K, Mortensen JH, Nagy B. Genetic Aspects of Preeclampsia and the HELLP Syndrome. J Pregnancy. BMC Res Notes. 2014 Jun 28;7(1):408.

  25. Patabendige M. Acute subdural haemorrhage in the postpartum period as a rare manifestation of possible HELLP (haemolysis, elevated liver enzymes, and low-platelet count)syndrome: a case report. J Matern Fetal Neonatal Med. 2014 Jun 30:1-5.

  26. Leeners B, Rath W, Kuse S, Tschudin S. The development of partnership after hypertensive diseases in pregnancy. J Matern Fetal Neonatal Med. 2014 Jun 30:1-7.

  27. Amorim MM, Katz L, Barros AS, Almeida TS, Souza AS, Faúndes A. Maternal outcomes according to mode of delivery in women with severe preeclampsia: a cohort study. J Clin Anesth. 2014 May;26(3):251-2.




2020     |     www.medigraphic.com