Part â…  Clinical Analysis Of 28 Cases Of Hemolysis, Elevated Serum Level Of Liver Enzymes And Low Platelets Syndrome

PART I CLINICAL ANALYSIS OF 28 CASES OF HEMOLYSIS, ELEVATEDSERUM LEVEL OF LIVER ENZYMES AND LOW PLATELETS SYNDROMEObjective: To investigate the age, gestational weeks of delivery, method of delivery, diagnosis , therapy, complications and the measures to decrease the incidence of HELLP syndrome.Methods: 28 cases with HELLP syndrome in our hospital from 2000 to 2006 were collected. The information collected from every patient for retrospective analysis.Results: The mean age of patient with HELLP syndrome in our data is 30. 84 years old, the disease were all diagnosed antepartum, mean gestational weeks of delivery is 36. 8weeks, rivanolinduction of labour was used in one case whose gestational weeks was less than 28 weeks, 12 cases w,ere premature delivery, 15 cases were term delivery, 26 cases ended their pregnancy by cesarean section. The main complications are premature delivery, FGR, placenta abruption, acute renal failure, DIC, ascites and etc. Therapeutic measure includes the therapy to hypertensive disorders in pregnancy, supportive treatment of the blood products, using glucocorticoid promptly and ending the pregnancy as soon as possible. Only one case in our data had an extremely poor prognosis and quit therapy, other patients are all discharge recovery. Fatality of perinatal baby is 17. 86%(5 cases ).Conclusion: HELLP syndrome is a kind of severe complication of pregnancy which induce high mortality and morbidity based on hypertensive disorders in pregnancy. That which measure can decrease the fatality of pregnancy woman and baby with HELLP syndrome includes early diagnosis , early supportive treatment, using glycocorticoid , ending the pregnancy as soon as possible and monitoring patient's condition closely. HELLP syndrome is one of the most severe complications, which can induce high morbidity and mortality although it has low incidence. HELLP syndrome is usually based on hypertensive disorders in pregnancy, it may be independent or a severe complication of preeclampsia. Etiology and pathogenesy of HELLP syndrome is still unknown nowadays, and it has no specific clinical manifestations, final diagnosis and the classification depends on the laboratory examination. HELLP syndrome should be identified with diseases of hepatic lesion, hemolytic disease and hemorrhagic disease in pregnancy because of the variety in the clinical manifestation. Therapy to HELLP syndrome includes to control hypertensive disorders in pregnancy, supportive treatment, glucocorticoid, delivery and symptomatic treatment to the complications The indication of expectant treatment and the juncture of delivery is still argued by some scholars at present. However, the condition of patients and the fetus should be monitored carefully during the treatment. Delivery can stop the development of disease, so it is the fundamental therapy to HELLP syndrome. Neonates of patients with HELLP syndrome are all high risk infants, so measures to rescue the neonates should be prepared. I hope this review article about the development of study in HELLP syndrome can do some help to the further study.