HELLP Syndrome
HELLP Syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the HELLP Syndrome to be a variant of preeclampsia, but it may be a separate entity. The pathogenesis of HELLP Syndrome remains unclear. Early diagnosis is critical because the morbidity and mortality rates associated with the HELLP Syndrome have been reported to be as high as 25 percent. Platelet count appears to be the most reliable indicator of the presence of HELLP Syndrome. The D-dimer test may be a useful tool for the early identification of patients with preeclampsia who may develop severe HELLP Syndrome. The mainstay of therapy is supportive management, including seizure prophylaxis and blood pressure control in patients with hypertension. Women remote from term should be considered for conservative management, whereas those at term should be delivered. Some patients require transfusion of blood products, and most benefit from corticosteroid therapy. Rarely, patients with refractory HELLP Syndrome require plasmapheresis. (Am Fam Physician 1999;60:829-39.)
The acronym HELLP was coined in 1982 to describe a syndrome consisting of hemolysis, elevated liver enzyme levels and low platelet count.1 The syndrome has been considered a variant of preeclampsia, but it can occur on its own or in association with preeclampsia. Pregnancy-induced hypertension, preeclampsia and HELLP Syndrome are related and overlap in their presentations. Because of the serious associated morbidity and mortality, family physicians who provide maternity care need to be aware of HELLP Syndrome so that they can identify it early.
HELLP Syndrome
OTHER RELATED INFORMATION
HELLP Syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the HELLP Syndrome to be a variant of preeclampsia, but it may be a separate entity. The pathogenesis of HELLP Syndrome remains unclear. Early diagnosis is critical because the morbidity and mortality rates associated with the HELLP Syndrome have been reported to be as high as 25 percent. Platelet count appears to be the most reliable indicator of the presence of HELLP Syndrome. The D-dimer test may be a useful tool for the early identification of patients with preeclampsia who may develop severe HELLP Syndrome. The mainstay of therapy is supportive management, including seizure prophylaxis and blood pressure control in patients with hypertension. Women remote from term should be considered for conservative management, whereas those at term should be delivered. Some patients require transfusion of blood products, and most benefit from corticosteroid therapy. Rarely, patients with refractory HELLP Syndrome require plasmapheresis. (Am Fam Physician 1999;60:829-39.)
The acronym HELLP was coined in 1982 to describe a syndrome consisting of hemolysis, elevated liver enzyme levels and low platelet count.1 The syndrome has been considered a variant of preeclampsia, but it can occur on its own or in association with preeclampsia. Pregnancy-induced hypertension, preeclampsia and HELLP Syndrome are related and overlap in their presentations. Because of the serious associated morbidity and mortality, family physicians who provide maternity care need to be aware of HELLP Syndrome so that they can identify it early.
HELLP Syndrome
No comments:
Post a Comment