Second and third trimesters :
HELLP Syndrome(hemolysis, elevated liver enzymes, low platelet counts) :
The HELLP syndrome is a multi-system disease variant of severe preeclampsia that is characterized by microangiopathic hemolytic anemia (MAH), hepatic dysfunction (hepatic necrosis), thrombocytopenia (platelet count, <100,000/ mm3) and the syndrome's most severe form, DIC.
HELLP syndrome is more common among older multiparous women.
HELLP syndrome affects up to 20% of pregnancies involving severe preeclampsia.
Although up to 11% of the cases occur before 27 weeks of gestation, most cases (70%) occur between 27 and 36 weeks of gestation and about a third occur after delivery.
Exacerbations may occur after delivery, followed by recovery within 72 hours.
Clinical manifestations:
Nausea, malaise, epigastric or right upper quadrant abdominal pain (65%–90% of cases) and edema.
DIC (21% of patients), abruptio placenta (16%), acute renal failure (8%) and pulmonary edema (6%).
The maternal mortality rate is approximately 1% to 4%, and the perinatal mortality rate ranges from 10% to 20%, depending on gestational age and severity of the condition at the time of delivery.
Maternal morbidity in HELLP syndrome can be classified into the following four categories (in decreasing order of frequency):
-Coagulation disorders associated with hemorrhagic complications
-Cardiopulmonary dysfunction
-Central nervous system disorder
-Hepatic or gastrointestinal dysfunction.
The risk for recurrence ranges from 4% to 25%.
Infants born to mothers with HELLP syndrome are at risk for thrombocytopenia.
HELLP Syndrome(hemolysis, elevated liver enzymes, low platelet counts) :
The HELLP syndrome is a multi-system disease variant of severe preeclampsia that is characterized by microangiopathic hemolytic anemia (MAH), hepatic dysfunction (hepatic necrosis), thrombocytopenia (platelet count, <100,000/ mm3) and the syndrome's most severe form, DIC.
HELLP syndrome is more common among older multiparous women.
HELLP syndrome affects up to 20% of pregnancies involving severe preeclampsia.
Although up to 11% of the cases occur before 27 weeks of gestation, most cases (70%) occur between 27 and 36 weeks of gestation and about a third occur after delivery.
Exacerbations may occur after delivery, followed by recovery within 72 hours.
Clinical manifestations:
Nausea, malaise, epigastric or right upper quadrant abdominal pain (65%–90% of cases) and edema.
DIC (21% of patients), abruptio placenta (16%), acute renal failure (8%) and pulmonary edema (6%).
The maternal mortality rate is approximately 1% to 4%, and the perinatal mortality rate ranges from 10% to 20%, depending on gestational age and severity of the condition at the time of delivery.
Maternal morbidity in HELLP syndrome can be classified into the following four categories (in decreasing order of frequency):
-Coagulation disorders associated with hemorrhagic complications
-Cardiopulmonary dysfunction
-Central nervous system disorder
-Hepatic or gastrointestinal dysfunction.
The risk for recurrence ranges from 4% to 25%.
Infants born to mothers with HELLP syndrome are at risk for thrombocytopenia.
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