MATERNAL AND FETAL OUTCOMES IN HELLP SYNDROME AT 23 WEEKS GESTATION: SYSTEMATIC REVIEW

Authors

  • I Made Elga Aldela Paramerta Dr. Harjono General Hospital, Ponorogo Regency, Indonesia

DOI:

https://doi.org/10.61841/1v9jdw27

Keywords:

Early gestation, HELLP syndrome, maternal hypertension, preeclampsia

Abstract

Introduction: Hypertensive disorders, affecting 5-10 of pregnancies, are a leading cause of maternal and perinatal mortality. Preeclampsia-eclampsia, a syndrome contributing to significant global deaths, demands prompt identification and management, particularly in resource-limited settings. Detecting and addressing early and late-onset preeclampsia are crucial for maternal and neonatal well-being.  HELLP syndrome, a severe complication of preeclampsia, presents diverse symptoms and risks, with a maternal mortality rate as high as 24 Understanding its outcomes in pregnancies before 23 weeks is essential to guide better management strategies for improved maternal and neonatal health in such critical cases.

Methods: The researchers in this study followed the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to ensure that their work met the required standards. This was done to ensure the precision and reliability of the conclusions derived from the research.

Result: Our search produced 15  results. After looking at the titles and summaries, we found 6  papers that fit our criteria. At first, we excluded one articles because they were written in a review style. But after reading the full papers carefully, we included four papers in our final analysis. These papers included a retrospective observational study and several case reports.

Conclusion: Occurrences of HELLP syndrome without associated hypertensive disorders and recurrent intrahepatic ruptures at extremely premature gestational ages are rare but pose significant risks to mothers and newborns. Swift diagnosis, pregnancy termination, and continuous monitoring are crucial to address early-onset HELLP syndrome, emphasizing the need for immediate attention and prompt management.

References

Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens

Duhig K, Vandermolen B, Shennan A. Recent advances in the diagnosis and management of pre-eclampsia.

Khalid F, Mahendraker N, Tonismae T. HELLP Syndrome.

Wadhwani P, Saha PK, Kalra JK, Gainder S, Sundaram V. A study to compare maternal and perinatal outcome in early vs. late onset preeclampsia. Obstet Gynecol Sci.

Matthew H. Mossayebi, Neel S. Iyer, Rodney A. McLaren, Hind N. Moussa, Baha M. Sibai, Huda B. Al-Kouatly, HELLP syndrome at 23 weeks gestation a systematic literature review, American Journal of Obstetrics and Gynecology

Mark, K., Flanagan, N., Hurvitz, J., & Chawla, K. (2021). Abortion in women with severe preeclampsia and eclampsia prior to 24 weeks gestation.

Kascak P, Paskala M, Antal P, Gajdosik R. Recurrent HELLP Syndrome at 22 Weeks of Gestation. Case Rep Obstet Gynecol.

Ugonna Aja-Okorie, Nnabuike Chibuoke Ngene, Atypical preeclampsia-eclampsia syndrome at 18 weeks of gestation A case report, Case Reports in Women's Health

Han GH, Kim MA. Recurrent spontaneous hepatic rupture in pregnancy A case report. Medicine (Baltimore).

World Health Organization Safe abortion: technical and policy guidance for health systems. 2nd ed; 2012

P, W. A., Ernawati, E., & Susanti, D. (2016). CHARACTERISTICS OF HELLP SYNDROME IN SEVERE PREECLAMPSIA PATIENTS IN DR. SOETOMO HOSPITAL SURABAYA.

Tschann, Mary; Edelman, Alison; Jensen, Jeffrey; Bednarek, Paula; Kaneshiro, Bliss (2017). Blood loss at the time of dilation and evacuation at 16 to 22 weeks of gestation in women using low molecular weight heparin: a case series.

I. P. M. Gaugler-Senden, A. G. Huijssoon, W. Visser, E. A. P. Steegers, and C. J. M. de Groot, “Maternal and perinatal outcome of preeclampsia with an onset before 24 weeks’ gestation. Audit in a tertiary referral center,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 128, no. 1-2, pp. 216–221, 2006.

S. M. Jenkins, B. B. Head, and J. C. Hauth, “Severe preeclampsia at 25 weeks of gestation: maternal and neonatal outcomes,” American Journal of Obstetrics & Gynecology, vol. 186, no. 4, pp. 790–795, 2002.

W. M. Merz and U. Gembruch, “Severe, early-onset hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome episode with spontaneous remission during pregnancy,” Journal ofMaternal-Fetal and Neonatal Medicine, vol. 20, no. 8, pp. 631- 632, 2007.

Roelofsen AC, van Pampus MG, Aarnoudse JG (2003). The HELLP-syndrome; maternal-fetal outcome and follow up infants. Journal Perinatal Medicine 31, 201- 208

Erkilinc S and Eyi EGY (2013). Adolescent pregnancies complicated by HELLP syndrome: clinical experience of 26 cases. The Journal of Gynecology- Obstetrics and Neonatology 10, 1643-1646

N.C. Ngene, J. Moodley, Blood pressure measurement in pregnancy and preeclampsia: devices, techniques, and challenges, Cardiovasc. J. Afr. 30 (20) (2019) 120–129.

L.A. Magee, G.N. Smith, C. Bloch, A.-M. Cˆot´e, V. Jain, K. Nerenberg, P. von Dadelszen, M. Helewa, E. Rey, Guideline No, 426: Hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management, J. Obstet. Gynaecol. Can. 44 (5) (2022).

L.A. Magee, M.A. Brown, D.R. Hall, S. Gupte, A. Hennessy, S.A. Karumanchi, L. C. Kenny, F. McCarthy, J. Myers, L.C. Poon, S. Rana, S. Saito, A.C. Staff, E. Tsigas, P. von Dadelszen, The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice, Pregnancy Hypertens 27 (2022) 148–169.

Society for Maternal-Fetal Medicine (SMFM), J.M. Louis, J. Parchem, A. Vaught, M. Tesfalul, A. Kendle, E. Tsigas, (Preeclampsia Foundation), Preeclampsia: a report and recommendations of the workshop of the Society for Maternal-Fetal Medicine and the Preeclampsia Foundation, Am. J. Obstet. Gynecol. 227 (5) (2022) B2–B24.

Downloads

Published

2023-12-06

How to Cite

Aldela Paramerta, I. M. E. . (2023). MATERNAL AND FETAL OUTCOMES IN HELLP SYNDROME AT 23 WEEKS GESTATION: SYSTEMATIC REVIEW. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 9(12), 16-24. https://doi.org/10.61841/1v9jdw27