산모 혈중 혈소판 최저치를 기준으로 한 HELLP 증후군 분류에 따른 산모-신생아 합병증의 비교 = Relationship between the Maternal-Fetal Complications and the Severity of HELLP Syndrome, Classified based on Maternal Platelet Count Nadir

다국어 초록 (Multilingual Abstract)

Objective : To determine the incidence of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and assess the relationship between the maternal-fetal complications and the severity of HELLP syndrome, classified based on platelet count nadir. Methods : We reviewed the maternal and neonatal charts of ten pregnancies complicated by HELLP syndrome, managed at Dankook University Hospital between January, 1995 and December, 2002. Women were divided into 2 groups as class Ⅰ HELLP which had a mate구미 platelet nadir ≤50,000/㎣, and class Ⅱ HELLP which had a maternal platelet nadir between >50,000 and 100,000/㎣. We compared the maternal and fetal complications between class Ⅰ and class Ⅱ HELLP syndrome. But we did not analyze statistically due to small number of patients. Results : There were four cases of class Ⅰ HELLP and six cases of class Ⅱ HELLP syndrome. The incidence of HELLP syndrome was 0.10% (10/10,238) in total deliveries and was 2.26% (10/443) in women with severe pre-eclampsia or eclampsia. The mean level of platelet counts nadir was 41,500/㎣ in class Ⅰ and 64,000/㎣ in class Ⅱ HELLP. The mean platelet recovery days (more than 100,000/㎣) were 6.0 and 4.2 days in each class. The mean values of the maximal aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) and uric acid might show no differences, but there might be difference in lactate dehydrogenase (LDH) levels which were 5854 and 1388 IU/L in each class. All patients with class Ⅰ HELLP syndrome showed maternal complications, but only one patient with class Ⅱ HELLP showed maternal complications. There might be no differences in the mean gestational ages and birth weights. The neonatal complications were similar in each class. Conclusion : Our data suggest that patients with class Ⅰ HELLP syndrome may be at increased risk for serious maternal complication, but the neonatal complications may be associated with gestational ages.

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