Course and delivery outcomes of 34 pregnancies complicated by HELLP syndrom

Authors: O. Šimetka 1;  I. Michalec 1;  H. Zewdiová 1;  R. Kolářová 2;  J. Procházková 3;  M. Procházka 4
Authors‘ workplace: Porodnicko-gynekologická klinika FN, Ostrava, přednosta MUDr. O. Šimetka 1;  Neonatologické oddělení FN, Ostrava, primářka MUDr. R. Kolářová 2;  Hemato-onkologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. K. Indrák, DrSc. 3;  Porodnicko-gynekologická klinika FN, Olomouc, přednosta doc. R. Pilka, Ph. D. 4
Published in: Ceska Gynekol 2010; 75(3): 242-247


To analyze the course and delivery outcomes of pregnancies complicated by HELLP syndrom and compare them to previously published data.

Retrospective cohort study.

Subject and method:
We analyzed pregnancy outcomes of 34 pregnancies complicated by HELLP syndrom of women who delivered at our hospital between years 2004 and 2009.

Department of Obstetrics and Gynecology, University Hospital Ostrava.

There were 34 pregnancies and deliveries complicated by HELLP syndrom between the years 2004 and 2009 (64 months). The average age of mothers was 28.5 years, the average gestational age at delivery time was 33 weeks and 4 days. Only 2 women delivered vaginaly, the other 32 delivered by cesarean section and the average weight of the newborn was 1930 g. There were 3 twin pregnacies. Twenty two (65%) patients had laboratory abnormalities in coagulation parameters but clinical signs of coagulation disorder were noted in 8 patients only (23.5%). Six patients recevied blood transfusions (18 units in total) and 9 patients received plasma transfusions (20 units in total). The average length of stay of mothers at intensive care unit was 3.2 days. There was no maternal mortality. One fetus was stillborn and 12 newborns (33.3%) had their early postnatal period complicated by severe morbidity.

Early diagnosis and active management is a major factor for the prevention of severe forms of HELLP syndrom which still remains one of the most severe complications of pregnancy.

Key words:
HELLP syndrom, complication, morbidity.


1. Aslan, H., Gul, A., Cebeci, A. Neonatal outcome in pregnancies after preterm delivery for HELLP syndrome. Gynecol Obstet Invest, 2004, 58, p. 96-99.

2. Bick, RL. Syndromes of disseminated intravascular coagulation in obstetrics, pregnancy and gynecology. Objective criteria for diagnosis and management. Hematol Oncol Clin North Am, 2000, 14, p. 999-1044.

3. Detti, L., Mecacci, F., Piccioli, A., et al. Postpartum heparin therapy for patients with the syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP) is associated with significant hemorrhagic complications. J Perinatol, 2005, 25, p. 236-240.

4. Ellison, J., Sattar, N., Greer, I. HELLP syndrome: mechanism and management. Hosp Med, 1999, 60, p. 243-249.

5. Ertan, AK., Wagner, S., Hendrik, HJ., et al. Clinical and biophysical aspects of HELLP syndrom. J Perinat Med, 2002, 30, p. 483-489.

6. Gul, A., Cebeci, A., Aslan, H., et al. Perinatal outcomes in severe preeclampsia-eclampsia with and without HELLP syndrome. Gynecol Obstet Invest, 2005, 59, p. 113–118.

7. Haram, K., Svendsen, E., Abildgaard, U. The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth, 2009, 26, 9, p. 8.

8. Katz, VL., Watson, WJ., Thorp, JM. Jr., et al. Treatment of persistent postpartum HELLP syndrome with plasmapheresis. Am J Perinatol, 1992, 9, p. 120-122.

9. Martin, JN. Jr., Files, JC., Blake, PG., et al. Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome. Am J Obstet Gynecol, 1990, 162, p. 128-137.

10. Osmanagaoglu, MA., Erdogan, I., Zengin, U., Bozkaya, H. Comparison between HELLP syndrome, chronic hypertension, and superimposed preeclampsia on chronic hypertension without HELLP syndrome. J Perinat Med, 2004, 32, p. 481-485.

11. Sibai, BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol, 2004, 103, p. 981.

12. Sibai, BM., Ramadan, MK., Usta, ISM. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP Syndrome). Am J Obstet Gynecol, 1993, 169, 4, p. 1000-1006.

13. Šimetka, O., Brychtová, P., Procházková, J., et al. Laboratorní změny aktivace endotelu u syndromu HELLP = Changes of endothelium activation in HELLP syndrome. Gynekolog, 2008, 17, 2, s. 54-56.

14. Taylor, FBJ., Toh, CH., Hoots, WK., et al. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost, 2001, 86, p. 1327-1330.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account