Introduction: HELLP syndrome (H: hemolysis, EL: elevated liver enzymes and LP: low platelets) is a form of severe preeclampsia (PE). The syndrome can be: complete or incomplete (with three analytical criteria, or only one or two); Class i, ii or iii (according platelets < 50,000; 50,000-100,000 or > 100,000/mm); postpartum or antepartum; with early or late installation (before or after the 34nd week of gestation). We describe and analyze characteristics and evolution observed in hypertensive pregnant patients who developed HELLP.

Material And Methods: Retrospective cohort with observation period of two years. It included pregnant hypertensive women who developed HELLP, during the course of their hospitalization in the maternity hospital of our tertiary care hospital.

Results: It included 318 hypertensive pregnant women. We observed 28 HELLP. Maternal age was 25.8 ±7.2 years and gestational age at diagnosis 31 ± 1 week. Hypertension was chronic in 4 and gestational in 24; eight had presented PE in the previous pregnancy. There were 10 complete and 18 incomplete syndromes; according to platelet disease there were 3 Class i, 16 Class ii and 9 Class iii. HELLP was postpartum in 3 and antepartum in 25: 18 early and 7 late. There were 17 patients who required intensive care and 10 developed complications linked to HELLP. No maternal deaths were recorded.

Conclusion: Presentation was variable, exhibiting mostly in gestational hypertension, antepartum and early. Incomplete form and class II thrombocytopenia were more frequent. Maternal complications were frequent but no deaths were observed.

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http://dx.doi.org/10.1016/j.hipert.2020.05.003DOI Listing

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