Clinical Study on 15 Cases of HELLP Syndrome

Objective:To investigate the better diagnosis and management through analyzing the clinical course and death cause of HELLP (hemolysis,elevated liver enzymes,and low platelets) syndrome.Methods:The clinical courses,laboratory findings,complications and outcomes of mother and fetus in 15 cases with HELLP syndrome were retrospectively reviewed during the past 6 years in our hospital.Results:The mean gestational age at delivery was 35.31±3 weeks.There were 12 cases of complete HELLP syndrome ( 2 occurred postpartum) and 3 cases of incomplete.All cases had elevated liver enzymes(45～580 U/L) ,and thrombocytopenia ( 6～74×109/L) .The maternal complications included ascites,renal failure,placental abruption,DIC,cerebral changes,eclampsia,postpartum hemorrhage,and one case occurred secondary thrombotic thrombocytopenic purpura (TTP) .All of them were given fresh frozen plasma and dexamethasone.Among them,two cases received extra plasma exchange,and one of them complicated with adult respiratory distress syndrome ( ARDS) .Two mothers were dead ( 13.33%) ( 1 was hernia of brain,1 was ARDS) .Perinatal mortality rate was 26.67% ( 1 was neonatal death,1 was stillbirth,2 were fetal death) .Conclusions:We emphasize to enhance the management and treatment of severe preclampsia,early diagnosis of HELLP syndrome,using large dosage of dexamethasone,and termination of the pregnancy within 24～48 hours.Avoiding overtransfusion and closely observing the laboratory findings and clinical changes within 72 hours after delivery,the prognosis of the mother and fetus can be improved.