Maternal and foetal outcome in HELLP syndrome at tertiary care hospital

Objective: to determine maternal and foetal outcome in patients of haemolysis, elevated liver enzyme and low platelet cont syndrome. methods: the descriptive case series was conducted at the gynae unit ii of civil hospital, karachi, over a period of 12 months in two episodes; first from december 28, 2006, to february 28, 2007, and then from september 1, 2007, to june 30, 2008. it comprised 40 consecutive women with pre-ecampsia and eclampsia along with altered platelet count who met the syndrome criteria. a pre-designed proforma was administered for data collection. maternal and foetal outcomes were noted. spss 10 was used for statistical analysis. result: among the 40 mothers, cesarean section was the most common outcome (n=24; 60%). pulmonary oedema was found in 2 (5%) cases, acute renal failure in 10 (25%), disseminated intravascular coagulation in 6 (15%), and abruptio placenta in 5 (12.5%). intrauterine growth restriction as a foetal outcome was observed in 18 (45%) cases. pre-term birth was the result in 20 (50%) cases, and perinatal mortality was high (n=23; 57.5%). conclusion: management and delivery of hellp syndrome patients should be performed at tertiary care centres, where highly trained obstetrician, neonatal intensive care unit personnel and multi-disciplinary facilities are available. correct diagnosis and timely intervention can decrease the risk of maternal and perinatal mortality.