			Home About us Contact

HELLP Syndrome (hellp + syndrome)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

CASE OF HELLP SYNDROME WITH AN UNUSUAL PRESENTATION

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2004
Yusuf Yazgan
[source]

Double inherited thrombophilias and adverse pregnancy outcomes: Fashion or science?

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2010
Giovanni Larciprete
Abstract Aim:, To determine to what extent double inherited thrombophilias are associated with adverse obstetric complications correlated with fetoplacental insufficiency, such as preeclampsia, hemolytic anemia elevated liver enzymes and low platelet count (HELLP) syndrome, gestational hypertension, fetal growth restriction (FGR), intrauterine death (ID), abruptio placentae and disseminated intravascular coagulopathy. Methods:, Pregnant women coming to delivery were retrospectively divided into two groups: group A (controls) and group B (cases). Patients belonging to group B had one of the following: severe preeclampsia, HELLP syndrome, gestational hypertension, FGR, intrauterine death, abruptio placentae of disseminated intravascular coagulopathy. We detected methylenetetrahydrofolate reductase (MTHFR) A1298C, MTHFR C677T, factor V Leiden, PAI-1, mutant prothrombin G20210A, plasma homocysteine, antithrombin III, protein S and activated protein C resistance. Normal pregnant women or pregnant women with double defects were enrolled in this study. Results:, The combination of MTHFR C677T mutation with PAI-1 (5G/5G) mutation was significantly linked with the occurrence of ID. HELLP syndrome was significantly related to the simultaneous presence of factor VIII and X mutations. The combination of MTHFR C677T with factor VIII mutation and the combination of factor II and V mutations were significantly related to the occurrence of abruptio placentae. We found an association between double isoforms MTHFR mutation and FGR. Conclusion:, It seems that some thrombophilias and a combination of thrombophilic factors carry a greater risk than others for a given adverse outcome. Further studies are needed to check the link between thrombophilic gene mutations and adverse pregnancy outcomes, such as recurrent miscarriages and deep venous thrombosis. [source]

Transient postpartum diabetes insipidus associated with HELLP syndrome

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2006
Ender Ellidokuz
Abstract Diabetes insipidus in pregnancy has different causes. The association of diabetes insipidus with disturbances of liver function has been reported, however, diabetes insipidus has rarely been reported in HELLP syndrome. We present a 23-year-old primigravida with a singleton gestation complicated by HELLP syndrome who developed postpartum diabetes insipidus. Labor was induced promptly to terminate pregnancy because of intrauterine fetal death and liver dysfunction. 1-deamino-8-D-arginine-vasopressin was administered. Diabetes insipidus and liver dysfunction resolved within 2 weeks. Development of diabetes insipidus may result from increased vasopressinase activity mainly caused by deterioration of liver functions caused by HELLP syndrome. In pregnant women with liver disease as a result of any cause, the development of diabetes insipidus should be assessed with particular attention. [source]

ORIGINAL ARTICLE: Human Serum Complement C3 and Factor H in the Syndrome of Hemolysis, Elevated Liver Enzymes, and Low Platelet Count

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 4 2009
Elif Ari
Problem, Hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP syndrome) is a life-threatening variant of severe pre-eclampsia in pregnant women. The complement system may play a role in the pathogenesis of this condition. We sought to determine serum complement 3 (C3) levels and its regulatory protein complement factor H (FH) in the HELLP syndrome. Method of study, Twenty-two pre-eclamptic patients with HELLP syndrome (mean age: 27.8 ± 6.2 years), 21 pre-eclamptic patients without HELLP syndrome (mean age: 27.5 ± 6.8 years) and 24 normotensive, healthy pregnant women (mean age: 26.1 ± 4.4 years) were included in this study. Serum concentrations of C3 and FH were measured in all participants. Results, Concentrations of C3 and FH did not differ significantly between the study groups. In patients with the HELLP syndrome, FH levels were positively associated with platelet count. Conclusion, These findings did not support a major role of complement activation in the HELLP syndrome. In patients with HELLP, lower levels of FH are correlated with a reduced platelet count. [source]

Low plasma volume following pregnancy complicated by pre-eclampsia predisposes for hypertensive disease in a next pregnancy

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2003
Robert Aardenburg
Objective A large number of women with a history of pre-eclampsia/HELLP have a low plasma volume at least six months postpartum. The objective of this study was to determine whether a low plasma volume in formerly pre-eclamptic women and HELLP patients is associated with an increased risk for recurrent hypertensive complications in a next pregnancy. Design Prospective observational study. Setting Tertiary obstetric centre. Sample Formerly pre-eclamptic women and controls. Methods In 316 women with a history of pre-eclampsia and/or HELLP, we measured, plasma volume along with haemodynamic, metabolic and haemostatic variables at least six months postpartum. A group of 22 healthy parous controls was used as a reference. After standardising plasma volume for body mass index, women were subdivided into normotensive and normal plasma volume (n = 199), normotensive and low plasma volume (n = 76) and hypertensive (n = 41) subgroups, which were compared for demography, clinical parameters and course of a next pregnancy. Main outcome measures Recurrent hypertensive disease of pregnancy. Results Relative to the normal plasma volume subgroup, normotensive women in the low plasma volume subgroup have a higher body mass index, a lower total vascular compliance and a shorter estimated systemic circulation time. They have a higher HOMA index and higher fasting triglyceride levels. In normotensive and hypertensive former patients alike, low plasma volume is associated with a higher recurrence of hypertensive complications in a next pregnancy compared with normotensive women with normal plasma volume. Conclusion Low plasma volume in normotensive women with a history of pre-eclampsia and/or HELLP is associated with overweight, reduced vascular compliance and insulin resistance and a predisposition for recurrent pre-eclampsia and HELLP syndrome in a next pregnancy. [source]

Aspirin (100 mg) used for prevention of pre-eclampsia in nulliparous women: the Essai Régional Aspirine Mère,Enfant study (Part 1)

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2003
Damien Subtil
Objective To reduce the incidence of pre-eclampsia in nulliparous women, in accordance with the suggestion of a recent meta-analysis that low dose aspirin might decrease this incidence by more than half if used early enough in and at a sufficient dose during pregnancy (more than 75 mg). Design Multicentre randomised double-blinded placebo-controlled trial. Setting Twenty eight centres in Northern of France and one in Belgium. Population Three thousand and two hundred ninety-four nulliparous women recruited between 14 and 20 weeks. Methods Randomisation to either 100 mg aspirin or placebo daily from inclusion through 34 weeks. Main outcome measures Preeclampsia was defined as hypertension (,140 and or 90 mmHg) associated with proteinuria (,0.5 g/L). Results The aspirin (n= 1644) and placebo (n= 1650) groups did not differ significantly in the mothers' incidence of pre-eclampsia (28 of 1632 [1.7%] vs 26 of 1637 [1.6%]; relative risk, RR, 1.08, 95% CI 0.64,1.83), hypertension, HELLP syndrome or placental abruption, or in the children's incidence of perinatal deaths or birthweight below the 10th centile. The incidence of babies with birthweight below the third centile was significantly higher in the aspirin group, with no explanation. The incidence of maternal side effects was higher in the aspirin group, principally because of a significantly higher rate of haemorrhage. Conclusions Aspirin at a dose of 100 mg does not reduce the incidence of pre-eclampsia in nulliparous women. Aspirin (100 mg) is associated with an increase in bleeding complications. [source]

Central retinal vein occlusion and HELLP syndrome

ACTA OPHTHALMOLOGICA, Issue 5 2000
Francisco J. Gonzalvo
ABSTRACT. Purpose: To present a rare case of central retinal vein occlusion in conjunction with the HELLP syndrome. Methods: A 30-year-old woman presented in the 28th week of her second pregnancy with severe pre-eclampsia with HELLP syndrome; delivery by caesarean section was recommended. Ten days later, the patient complained of severely decreased visual acuity in her right eye. Results: Ophthalmoscopy revealed a central retinal vein occlusion with venous engorgement and tortuosity, multiple flame hemorrhages, and disc and macular edema. Electroretinography revealed a reduction of b-wave/a-wave ratio. Fluorescein-angiography showed a blockage due to extensive retinal hemorrhages with late mild staining of the walls of veins. The patient presented a spontaneous improvement in visual acuity (0.8 two months after) and a complete resolution of ophthalmoscopic findings. Conclusion: Ophthalmic complications are possible during and soon after this syndrome. This is the first description of a patient suffering a central retinal vein occlusion during puerperium after the HELLP syndrome. [source]

Lack of correlation between fatty acid oxidation disorders and haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome?

ACTA PAEDIATRICA, Issue 1 2005
M. Holub
Abstract Aim: Fatty acid ,-oxidation defects comprise a heterogeneous group of disorders that may precipitate acute life threatening metabolic crises particularly during catabolic episodes. Several studies have demonstrated a possible association between fatty acid ,-oxidation defects, including long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency and severe pregnancy complications. However, the precise percentage of women with haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome associated with foetal fatty acid ,-oxidation defects is not known. Methods: We carried out a multicentre retrospective study on 88 infants, born to women with HELLP syndrome. Acylcarnitine profiles from blood dried on filter paper cards were analysed by tandem mass spectrometry for the diagnosis of fatty acid ,-oxidation defects. In addition, we screened for the common long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency mutation using a standard restriction fragment length polymorphism polymerase chain reaction method. Results: None of the infants studied carried the common long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency mutation. There was no evidence of fatty acid ,-oxidation defects, including long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, as expected by unremarkable acylcarnitine profiles, while three infants with fatty acid ,-oxidation defects were diagnosed in the control group. Conclusions: Neither foetal long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency, including heterozygosity for the common long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency mutation, nor fatty acid ,-oxidation defects in general are a major risk factor for HELLP syndrome in Austria. [source]