HELLP syndrome: Understanding and management of a pregnancy-specific disease

@article{Aloizos2013HELLPSU,
  title={HELLP syndrome: Understanding and management of a pregnancy-specific disease},
  author={Stavros Aloizos and Charalampos Seretis and Nikolaos Liakos and Paraskevi Aravosita and Christina Mystakelli and Efthymia Kanna and Stavros Gourgiotis},
  journal={Journal of Obstetrics and Gynaecology},
  year={2013},
  volume={33},
  pages={331 - 337}
}
HELLP, a syndrome characterised by haemolysis, elevated liver enzymes and low platelets, a variant of pre-eclampsia/eclampsia, is a multisystemic disorder with an incidence of up to 0.9% in all pregnancies and occurs in about one-quarter of pre-eclamptic patients. Most obstetricians presume that HELLP derives from an autoimmune reaction, leading to a materno– fetal imbalance, with accompanying aggregation of platelets, endothelial malfunction along with inborn errors of fatty acid oxidative… 
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43 Citations
Highly Influential Citations
3
Background Citations
15
Methods Citations
1

43 Citations

Citation Type

Citation Type

HELLP-syndrome as a life-threatening condition: current clinical considerations
TLDR
In the above clinical situations, the diagnostic judgement should be pointed towards the HELLP-syndrome; accordingly, the adequate obstetric management should be initiated to prevent the development of life-threatening complications in both the mother and the fetus.
Actualización y conceptos claves del Síndrome de HELLP
TLDR
The diagnosis is made by the triad: microangiopathic anemia, elevated liver enzymes and thrombocytopenia, and the treatment is primarily symptomatic and to perform the delivery between 24-48 hours post diagnosis.
Revisiting HELLP syndrome.
HELLP Syndrome Complicated with Ascites during Third Trimester of Pregnancy – Therapeutic Management
TLDR
The case of a 25 year old patient, 37 weeks pregnant, who was admitted to “Elena Doamna” Clinical Hospital of Obstetrics and Gynecology, Iasi, Romania, for uterine contractions, spontaneous ruptured membranes, lower-extremity edema, high blood pressure, and a large amount of ascitic fluid is reported.
Undiagnosed Wilson’s Disease, Mimicking HELLP Syndrome during Puerperium
Inthisreport, the case of a young Greek primigravida who showed the clinical features of hemolysis, elevated liver enzymes and HELLP syndrome after an elective caesarian section is discussed. Further…
Maternal Characteristics, Pregnancy, and Neonatal Outome in Preeclampsia and HELLP Syndrome: a Comparative Study
TLDR
There is significant difference in gestational age at delivery, nullipara, blood pressure, and laboratory findings (urea, creatinine, uric acid, albumin) between preeclampsia and HELLP syndrome group.
Surgical prophylaxis of bleeding during an the operative delivery in a patient with HELLP syndrome
TLDR
It is proposed to use a preventive application of compression sutures to the uterus during surgical delivery to reduce the risk of uterine bleeding in this group of patients.
Síndrome HELLP en embarazos pretérmino: evidencia fisiopatológica para uso de corticoides anteparto
TLDR
C corticosteroid therapy may be useful in stabilizing antepartum patients between 48-72 hours to ensure the move to more complex centers, in reducing recurrence of HELLP syndrome, in expectant management in preterm pregnancies and reducing transfusion need; however, more studies are needed to assess this indications.
A review of the alternative pathway of complement and its relation to HELLP syndrome: is it time to consider HELLP syndrome a disease of the alternative pathway
TLDR
The review will further discuss pregnancy as a major trigger of the alternative pathway, and how diseases of the APC are treated during pregnancy, and the similarities between HELLP syndrome and diseases ofThe APC will be examined.
May human epididymis 4 protein play a role in the etiopathogenesis of hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome?
TLDR
The relationship between HELLP syndrome and HE4 protein is investigated and a biomarker that can be utilized in the diagnosis of HELLP Syndrome is identified to identify a biomarkers associated with vascular damage.
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References

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The HELLP syndrome: Clinical issues and management. A Review
TLDR
Before 34 weeks' gestation, delivery should be performed if the maternal condition worsens or signs of intrauterine foetal distress occur, and standard corticosteroid treatment is of uncertain clinical value in the maternal HELLP syndrome.
WITHDRAWN: Corticosteroids for HELLP syndrome in pregnancy.
TLDR
There is insufficient evidence to determine whether adjunctive steroid use in HELLP syndrome decreases maternal and perinatal mortality, major maternal andPerinatal morbidity.
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TLDR
The recognition of HELLP syndrome and the rapid initiation of therapy are required for the improvement of materno-fetal prognosis.
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Corticosteroids for the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): what evidence?
TLDR
It is concluded that corticosteroids administration, either antepartum or postpartum, does not improve the outcome of pregnancies affected by HELLP syndrome and should not be used outside the setting of an approved investigational protocol.
Corticosteroids for the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP): what evidence?
TLDR
It is concluded that corticosteroids administration, either antepartum or postpartum, does not improve the outcome of pregnancies affected by HELLP syndrome and should not be used outside the setting of an approved investigational protocol.
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TLDR
The reader should be able to outline the history of HELLP syndrome and describe the pathophysiology of HELLp syndrome, to summarize the clinical presentation and differential diagnosis of HellP syndrome, and to list the various management options.
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TLDR
Patients with HELLP syndrome should receive anti-seizure prophylaxis with magnesium sulfate, treatment for severe hypertension, and correction of coagulopathy, if present.
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