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HELLP syndrome in a district hospital on the west coast in South India – a 5 year review

Kushtagi, Pralhad and Boopathy, Ajantha HELLP syndrome in a district hospital on the west coast in South India – a 5 year review. International Journal of Obstetrics &Gynaecology, 120 (Supl 1). p. 74.

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Abstract

Objective: To determine the incidence, maternal characteristics and pregnancy outcome in women with HELLP syndrome Materials and Methods:Analysis of case records of women with hypertension in pregnancy from December 2007 to November 2012 was carried out. The cases were identified from the pregnancy hypertension registry maintained by the department and the corresponding files were retrieved from the hospital medical records section. A Mississippi criterion was used for the diagnosis of HELLP syndrome. The details of patient characteristics, course of pregnancy and outcome of cases with HELLP syndrome were compiled. Observations:During the study period the incidence of hypertension in pregnancy was 10.08% (2263 0f 22435 deliveries) and that of HELLP syndrome was 1.23% among hypertensives (28 cases of 2263). Mean age of patients was 28.8∓ 5.05 years (67% were between 20-29 years). Occurrence was commoner in primigravidas (17 cases, 61%). Although most of the cases were after 28 weeks of pregnancy, three cases (10.07%) presented prior to this period of pregnancy. Most of the casers (85%) were detected to have HELLP syndrome between 28 and 38 weeks of pregnancy. There was a trend suggesting seasonal influence on complication with HELLP being more common in monsoon and winter. Presentation of cases with different severity of classes showed that half of them (53%) were in class II with less than two-fifths having severe disease (5 of 28 cases, 17%). Antepartum transfusion was necessitated in 13 cases (46% of 28), most of them who had evidence of hemolysis in addition to thrombocytopenia. Intensive unit care was required in 28% of the cases and acute renal failure was the common complication (28%). There were five maternal deaths (18% of 27 cases) that included all with the disease prior to 28 weeks. The group had 19 perinatal deaths (73% of 26 cases) and one of them due to birth asphyxia. Conclusions:Incidence of HELLP syndrome is seen more commonly during monsoon and winter. Maternal death is near inevitable if the disease manifests before 28 weeks of pregnancy.

Item Type: Article
Uncontrolled Keywords: HELLP syndrome, seasonal variation
Subjects: Medicine > KMC Mangalore > Obstetrics & Gynaecology
Depositing User: KMCMLR User
Date Deposited: 20 Aug 2013 07:02
Last Modified: 20 Aug 2013 07:02
URI: http://eprints.manipal.edu/id/eprint/136816

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