The importance of parity to major maternal morbidity in the eclamptic mother with HELLP syndrome

Objective: To determine if the rate of major morbidity from severe preeclampsia with/without hemolypis, elevated liver enzymes and low platelets (HELLP) syndrome differs by parity. Methods: Retrospective investigation of 970 gravidas with severe preeclampsia with and without HELLP syndrome analyzed according to parity. Results: Altogether 609 (63%) patients were nulliparous and 361 (37%) parous. Between groups there was no significant difference in the incidence of overall major morbidity (21% vs 19%, p = 0.467), or specific morbidities including hematologic/coagulopathic (13.6% vs 11.9%, p = 0.442), cardiopulmonary (8.9% vs 7.2%, p = 0.362), CNS/visual (1.8% vs 2.8%, p = 0.319), or hepatorenal (0.8% vs 2.2%, p = 0.068). Although eclampsia was significantly more common in nulliparas (10.2%) than in parous patients (5.5%, p = 0.012), the latter significantly more often demonstrated major maternal morbidity associated with eclampsia (50%) than did nulliparous patients (25%, p = 0.043). Conclusions: Unless p...