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Observational Study
. 2019 Jan 3;16(1):109.
doi: 10.3390/ijerph16010109.

Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre

Kestutis Rimaitis  1 , Lina Grauslyte  2 , Asta Zavackiene  3 , Vilda Baliuliene  4 , Ruta Nadisauskiene  5 , Andrius Macas  6
Affiliations
Observational Study

Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre

Kestutis Rimaitis et al. Int J Environ Res Public Health. .

Abstract

HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome is a severe and rapidly progressing condition that requires distinct diagnostic considerations. The aim of this study was to evaluate the impact of the Mississippi triple-class system on the HELLP syndrome diagnosis, treatment, and outcomes in a perinatology centre during a 10-year period, and consider its effectiveness and necessity in everyday practice. A retrospective observational cohort study was carried out using the medical records of a tertiary perinatology centre with the diagnosis of HELLP syndrome from the period of time between 2005 and 2014. The patients who fit the HELLP syndrome diagnosis were grouped by the Mississippi triple-class system. The means of diagnosis and treatment outcomes within those groups were analysed statistically. There was insufficient statistical evidence of the blood pressure levels corresponding to the severity of patients' condition (p > 0.05 in all of the groups). The clinical presentation varied within all of the classes, and the only objective means of diagnosis and evaluation of progression of the condition were laboratory tests. Even though HELLP syndrome is considered a hypertensive multi-organ disorder of pregnancy, the level of hypertension does not correlate to the severity of the condition; hence, the diagnosis should be based on biochemical laboratory evidence. Vigilance in suspicion and the recognition of HELLP syndrome and appropriate treatment are essential in order to ensure better maternal and neonatal outcomes.

Keywords: HELLP syndrome; Mississippi protocol; diagnostic criteria; pregnancy-related hypertension.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Initial presentation and progression of severity of the condition.
Figure 2
Figure 2
Dynamic changes of platelet count; PLT—platelet count.
Figure 3
Figure 3
Dynamic changes of blood aspartate aminotransferase levels; AST—aspartate aminotransferase.
Figure 4
Figure 4
Dynamic changes of blood lactate dehydrogenase levels; LDH—lactate dehydrogenase.
See this image and copyright information in PMC

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