and 3 other(s)
Background and Goal of Study: HELLP Syndrome is characterized by hemolysis, elevated liver enzymes and low platelet levels. It’s an important obstetric syndrome with an average maternal mortality rate of 5%. It usually presents with elevated blood pressure and a variety of symptoms. We reviewed the anesthetic management of women diagnosed with HELLP syndrome in our institution in 5 years and describe the outcomes. Materials and Methods: Retrospective, observational study from January 2012 to December 2016 in women with diagnosis of HELLP syndrome. Data were collected from physical and electronic processes and the following variables were included: Age, obstetric history, type of delivery, anesthetic management, maternal and fetal outcome and complications, ICU admission and discharge date. All data was compiled and analysed using SPSS version 22. Results and Discussion: There were 12 pregnant women diagnosed with HELLP syndrome in the 5 years period, in a total of 9708 deliveries (0,12%). The syndrome was classified antepartum in 7 patients. The median age was 33 years and 66,6% presented after the 35th week. In 7 cases the syndrome developed in the first pregnancy. All women received corticosteroid treatment and antihypertensive drugs, as well as seizure prophylaxis with magnesium sulfate. Emergency cesarean section was performed in 10 women using general anesthesia in 6 of them. ICU admission was necessary in 4 cases. The median time until discharge was 9 days. There were 2 fetal deaths in patients arriving to the hospital with no fetal heart rate in cardiotocography and 1 baby was admitted to NICU after cesarean delivery. Conclusion(s): HELLP syndrome is an obstetric emergency in which a multidisciplinary approach (obstetricians, paediatricians and anaesthesiologists) is vital to a successful outcome. Early recognition of signs and symptoms and prompt treatment is necessary to decrease maternal and fetal morbimortality.
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