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Whether HELLP syndrome is a distinct entity or a severe form of preeclampsia, itremains a factor of gravity. Described by Weinstein in , it associates hemolysis,cytolysis elevated liver enzymes and thrombopenia low platelets.
The cut off for thebiological parameters have to be strictly defined to avoid overdiagnosis of HELLPsyndrome. The difficulty to diagnose this syndrome is real because most of the associatedclinical signs are aspecific.
The mean term of delivery is 32 weeks, the prematurity being widely induced becauseof the fear of maternal complications. Maternal deaths 1. Subcapsular hematomas of the liver are unfrequent 0. Rapid termination of pregnancy, by vaginal delivery or by cesarean, is generallyrecommended when the fetal lung maturity is obtained or when maternal complicationsappear. Conversely, conservative management is acceptable before 32 weeks.
Corticosteroidtherapy or hemodynamic therapy could allow to obtain fetal lung maturity. A conservativeapproach requires permanent materno-fetal follow-up which can only be achieved in aperinatal center integrating a neonatal intensive care unit.
Lorsque les globules rouges se fragmentent dans lamicrocirculation, ils forment des schizocytes. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count :a severe consequence of hypertension in pregnancy.
Am J Obstet Gynecol ; Intravascular hemolysis,thrombocytopenia and other hematologic abnormalities associated with severe toxemia ofpregnancy. New Engl J Med ; Obstet Gynecol ; 66 Hellp syndrome : pathologic entity or technicalinadequacy?
Preeclampsia associated with hemolysis, elevatedliver enzymes, and low platelets. An obstetric emergency? Obstet Gynecol ; 62 Faut-ilindividualiser le Hellp syndrome? J Gynecol Obstet Biol Reprod ; 16 Le Hellp syndrome. A propos de 13 observations. J Gynecol Obstet Biol Reprod ; 21 Pregnancies complicated by HELLPsyndrome hemolysis, elevated liver enzymes, and low platelets : subsequent pregnancyoutcome and long-term prognosis.
Therecurrence risk of the syndrome of hemolysis, elevated liver enzymes, and low platelets HELLP in subsequent gestations. Thrombocytopenia inpreeclampsia : associated abnormalities and management principles. Am J Obstet Gynecol; Perinatal results ofhemodynamic and conservative temporizing treatment in severe pre-eclampsia.
Sibai BM. ObstetGynecol Clin North Am ; 18 Theinterrelationship of eclampsia, HELLP syndrome, and prematurity : cofactors forsignificant maternal and perinatal risk. Br J Obstet Gynaecol ; Maternal-perinataloutcome associated with the syndrome of hemolysis, elevated liver enzymes, and lowplatelets in severe preeclampsia-eclampsia.
A syndrome of liverdamage and intravascular coagulation in the last trimester of normotensive pregnancy. Aclinical and histopathological study. Br J Obstet Gynaecol ; 93 Disseminatedintravascular coagulation and the syndrome of hemolysis, elevated liver enzymes, and lowplatelets in severe preeclampsia.
Obstet Gynecol ; 73 Hepatichistopathologic condition does not correlate with laboratory abnormalities in HELLPsyndrome hemolysis, elevated liver enzymes, and low platelet count [see comments]. Am JObstet Gynecol ; Spontaneous resolution ofpre-eclampsia-related thrombocytopenia.
Br J Obstet Gynaecol ; 99 Maternal morbidityand mortality in pregnancies with hemolysis, elevated liver enzymes, and low platelets HELLP syndrome [see comments]. J Gynecol Obstet Biol Reprod; 23 Maternal hemolysis, elevated liver enzymes, lowplatelet count, and neonatal outcome. Am J Perinatol ;1 2 Antepartumcorticosteroids : disease stabilization in patients with the syndrome of hemolysis,elevated liver enzymes, and low platelets HELLP.
Visser W, Wallenburg HC. Factorsrelevant to mode of preterm delivery with syndrome of HELLP hemolysis, elevated liverenzymes, and low platelets. Theintrapartum platelet count in patients with HELLP hemolysis, elevated liver enzymes, andlow platelets syndrome : is it predictive of later hemorrhagic complications? Am J ObstetGynecol ; Postpartum corticosteroids : accelerated recovery from the syndrome of hemolysis, elevatedliver enzymes, and low platelets HELLP.
Postpartumplasma exchange for atypical preeclampsia-eclampsia as HELLP hemolysis, elevated liverenzymes, and low platelets syndrome.
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