Introduction: HELLP syndrome is a complication of severe preeclampsia; its incidence goes from 0.1 to 0.6% of pregnancies, and causes complications in 4% of patients.
Objective: To evaluate frozen fresh plasma administration to prevent pregnancy complications in patients with HELLP syndrome.
Patients And Methods: Retrospective, comparative and non-randomized study. Patients with HELLP syndrome were divided in two groups: first one (n=23) was treated with fresh frozen plasma (10 mL/kg/day), and second one (n=29) with dexamethasone. Complications, dialysis requirement, hospital stay, and mortality were compared (chi2 test was used).
Results: Group 1 (n=23) had nine patients with HELLP syndrome type I, and 14 with type II. Group 2 (n=29) had 20 cases with HELLP syndrome type I, and nine with type II. Most frequent complication in group 1 was acute renal failure (22%), and hospital stay was 4.5 days. Group 2 had 13 patients with acute renal failure, three with pulmonary edema, one with cerebral edema, one with hepatic fracture, and one with placenta detachment. Hospital stay was from 8 to 30 days (p < 0.002). There were no maternal deaths in both groups.
Conclusions: Fresh frozen plasma meaningfully reduces (43%) complications, hospital stay, and hemodialysis requirement (45%) in patients with HELLP syndrome.
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Herein, we report the cases of two patients with hemolysis, elevated liver enzymes, and low platelets syndrome who underwent emergent Cesarean sections that were complicated by massive hemorrhage due to undiagnosed hepatic rupture. Intraoperative General Surgery team intervention, early activation of massive transfusion protocol, hemostatic resuscitation, and transfer to ICU resulted in the survival of both patients.
View Article and Find Full Text PDFArch Gynecol Obstet
January 2025
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
Background: sFLT-1 has been implicated in the pathogenesis of HDP. We aimed to examine the role of maternal and fetal polymorphisms in risk of HDP and severe-spectrum disease.
Methods: Cases of HDP (143) and controls (169) from mother-baby dyads were recruited at the Los Angeles County Women's and Children's Hospital (WCH).
Heliyon
December 2024
Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
Introduction: The hemolysis-elevated liver enzymes-low platelet counts (HELLP) syndrome and posterior reversible encephalopathy syndrome (PRES) are rare conditions that can complicate pregnancy and the early postpartum period. Although both are closely related to hypertensive pregnancy disorders, their association is rarely described, so the outcome of these patients remains unknown. We present a case report of PRES associated with HELLP syndrome and a review of all previously published cases, including demographic characteristics, clinical presentation, treatment, and outcome.
View Article and Find Full Text PDFEur J Case Rep Intern Med
December 2024
Critical Care, Intensive Care Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
Unlabelled: Haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a poorly understood, life-threatening multisystemic condition related to pregnancy with a rapid onset, typically observed in patients with severe pre-eclampsia. Various mechanisms may lead to diffuse endothelial damage associated with HELLP and possible brain involvement. A comprehensive review of PubMed, Embase and Cochrane databases was conducted to examine the clinical, laboratory and radiological features associated with postpartum HELLP syndrome, particularly its potential association with posterior reversible encephalopathy syndrome (PRES).
View Article and Find Full Text PDFObstet Gynecol
January 2025
Division of Maternal-Fetal Medicine, Department of Obstetrics Gynecology and Reproductive Sciences, University of Texas Health Science Center at Houston, Houston, Texas.
Objective: To describe the presentation, outcomes, and management strategies for cases of subcapsular liver hematoma associated with preeclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.
Methods: This was a case series of individuals with subcapsular liver hematoma managed at a single level IV center over a 10-year period, from 2013 to 2024. Presenting signs and symptoms, laboratory findings, time of onset, management strategies, acute perinatal and maternal outcomes, and long-term outcomes such as subsequent pregnancies were reviewed in the medical record and recorded.
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