ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Risk Factors for Perinatal Loss in Women with HELLP Syndrome

DOI:10.31550/1727-2378-2019-159-4-23-27
Bibliography link: Tsoy V.Yu., Olimova F.Z., Uzakova U.D., Dodkhoyeva M.F., Abdullayeva R.A., Mukhamadieva S.M. Risk Factors for Perinatal Loss in Women with HELLP Syndrome. Doctor.Ru. 2019; 4(159): 23–27. DOI: 10.31550/1727-2378-2019-159-4-23-27
30 April 08:00

Objective of the Study: To identify risk factors for perinatal morbidity and mortality in women with severe pre-eclampsia complicated by HELLP syndrome.

Study Design: This was a retrospective, comparative study.

Materials and Methods: The study included evaluation of perinatal outcomes in 268 pregnant women who gave birth at second- and third-level maternity homes in the Republic of Tajikistan. The main group consisted of 36 women whose pregnancies were complicated by severe pre-eclampsia and HELLP syndrome, and their newborns. In the comparison group were 232 women with severe pre-eclampsia who did not have HELLP syndrome, and their newborns.

Study Results: Of the 36 newborns in the main group, six babies (16.7%) born at 29-33 weeks died in the early neonatal period: two (5.6%) had grade 3 fetal growth restriction and four (11.1%) died of infant respiratory distress syndrome accompanied by intrauterine pneumonia. Of the 232 babies in the comparison group, two (0.9%) were stillborn and five (2.2%) died in the early neonatal period.

In the main group 83.3% of the women had irregularly contracted and dysmorphic RBC, fragmented RBC (schistocytes), and red cell polychromasia. Similar changes were observed in the six women with HELLP syndrome whose babies died in the early neonatal period, while in the comparison group women with poor perinatal outcomes did not have such changes. All women in the main group had thrombocytopenia with platelet levels between 70×109/L and 112×109/L. A significant reduction of platelet levels led to bleeding in three women; and five out of the 36 newborns were diagnosed with intraventricular hemorrhage. Blood levels of ALT in the patients with HELLP syndrome ranged from 57 to 170 U/L. Mothers whose infants died within the first seven days of life had the highest ALT blood levels—120-170 U/L.

Analysis of perinatal mortality showed that all of the women with HELLP syndrome had markedly elevated bilirubin levels and abnormal proteinuria (3.3-13.2 g/L).

Conclusion: Severe pre-eclampsia complicated by HELLP syndrome is a high-risk factor for poor perinatal outcomes. In women with HELLP syndrome, the risk factors for poor perinatal outcomes include prematurity, severe thrombocytopenia, proteinuria, hyperbilirubinemia, and schistocytes in the peripheral blood.

The authors declare that they do not have any conflict of interests.

V.Yu. Tsoy — Avicenna Tajik State Medical University; 139 Rudaki St., Dushanbe, Republic of Tajikistan 734003. E-mail: VTFrangasNonFlectas@gmail.com

F.Z. Olimova — Avicenna Tajik State Medical University; 139 Rudaki St., Dushanbe, Republic of Tajikistan 734003. E-mail: farangis-z@mail.ru

U.D. Uzakova — Avicenna Tajik State Medical University; 139 Rudaki St., Dushanbe, Republic of Tajikistan 734003. E-mail: urunbish@inbox.ru

M.F. Dodkhoyeva — Avicenna Tajik State Medical University; 139 Rudaki St., Dushanbe, Republic of Tajikistan 734003. E-mail: dodkho2008@mail.ru

R.A. Abdullayeva — Avicenna Tajik State Medical University; 139 Rudaki St., Dushanbe, Republic of Tajikistan 734003. E-mail: ranoshechka74@mail.ru

S.M. Mukhamadieva — Institute of Postgraduate Healthcare Education; 78 Ismail Samani Prospect, Dushanbe, Republic of Tajikistan 734026. E-mail: saohon@mail.ru

Доктор.ру
30 April 08:00
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