OUR EXPERIENCE ABOUT HELLP SYNDROME IN INTENSIVE CARE UNIT

Abstract

Aim: HELLP syndrome is a life-threatening condition frequently associated with severe preeclampsia-eclampsia and is characterized by hemolysis, elevated liver enzymes and low plateletes. The aim of our study was to evaluate retrospectively the patients with HELLP syndrome admitted to the intensive care unit (ICU). Material and Methods: We retrospectively reviewed the medical records of 19 patients with HELLP syndrome admitted to ICU between January 2011 and December 2015. Results: The mean maternal age was 30.0 ± 5.1 years and the mean gestational age was 32.2 ± 4.8 weeks of 19 patients with HELLP syndrome admitted to the ICU. The mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, Glasgow Coma Scale (GCS) were 25.9 ± 4.0, 14.2 ± 2.8 and 5.2 ± 2.7 at ICU admission, respectively. Mechanical ventilation was required for 12 patients (63.6%). Eight patients (42.1%) had acute kidney injury and only 1 patient was required renal replacement therapy. Therapeutic plasma exchange was performed to 11 patients (57.9%). Three patients (15.8%) had dissemine intravascular coagulation (DIC), 5 patients (26.3%) acute respiratory distress syndrome (ARDS), 3 patients (15.8%) septic shock, and 1 patient (5.3%) cardiogenic shock. The mean length of ICU stay was 8.1 ± 4.7 days. Both of maternal and fetal mortality rate was 10.5%. Conclusion: Maternal/fetal morbidity and mortality are high in HELLP syndrome. Early diagnosis, close follow-up in intensive care unit, appropriate treatment and management by multidisciplinary team may prevent complications and improve prognosis of HELLP syndrome.