نوع مقاله : اصیل پژوهشی
1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران
2 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران
3 پزشک عمومی، بیمارستان شهید اکبر آبادی، دانشگاه علوم پزشکی ایران، تهران، ایران
عنوان مقاله [English]
Introduction:HELLP syndrome is one of the severe complications of preeclampsia which is accompanied by serious fetal and maternal effects. The purpose of the present study is to evaluate the maternal and neonatal complications of the HELLP syndrome and its risk factors.
Methods: A retrospective study was performed on the documentations of 46628 women who were delivered during 5 years in Akbarabadi Hospital. There were 1811 cases (3.88%) of preeclampsia. 1380 cases of preeclampsia had complete documentation records which were evaluated for the study. 1196 patients were Iranian and 184 patients were Afghans. The preeclamptic patients were divided into two groups; patients with HELLP syndrome (case group; 164 cases) and patients without HELLP syndrome (control group; 1216 cases). Characteristic of these two groups were then compared.
Results: There were 46628 deliveries and 1811 cases of preeclampsia (3.88%). 164 cases (11.9%) out of 1380 preeclamptic patients who had complete documentation records had HELLP syndrome. The mean platelet count of case and control groups were 81.3 ± 20.4×103/mm3 and 198.1± 55.9×103 /mm3, respectively (p<0.001). The mean proteinuria in case and control group were 3.26± 0.9 and 2.53±1.25 grams, respectively (p<0.001). The mean gestational age at the time of termination were 33.85±4.21 and 35.9±3.43 weeks in case and control group, respectively (p<0.002). There were no significant difference between two groups in their maternal age, parity, systolic and diastolic blood pressure and bilirubin and cesarean deliveries. Neonatal death [72 cases (44%) VS 170 cases (14%), p=0.001], fetal complications [116 cases (71%) VS 389 cases (32%), p=0.003], maternal symptoms [116 cases (71%) VS. 389 cases (32%), p=0.002] were higher in case group. The incidence rate of HELLP syndrome was not different between Iranian (145 cases; 12%) and Afghans (19 cases; 10%). Neonatal death [68 cases (47%) VS 5 cases (25%), p=0.003], fetal complications [106 cases (73%) VS 10 cases (50%), p=0.02] were higher in Iranian women. Also in control group the mentioned complications were more prevalent among Iranian women.
Conclusion: Being Iranian or Afghan does not influence the incidence of HELLP syndrome. However, further amount of proteinuria, lower gestational age at the time of onset of preeclampsia symptoms and also maternal risk symptoms like headache, epigastric pain and blurred vision are risk factors for HELLP syndrome.