Evaluation of Maternal and Perinatal Outcomes in Severe Preeclampsia with and Without HELLP Syndrome

Objective: Our objective is to evaluate maternal and perinatal outcomes in severe preeclampsia cases with HELLP syndrome (hemolysis, raised liver function tests, low platelet count) and severe preeclampsia cases without HELLP syndrome. Methods: Pregnant women with severe preeclampsia who had been diagnosed and delivered at our hospital between January 1015 and July 2018 were evaluated retrospectively. Patients were divided into two groups as those with HELLP syndrome (Group 1) and as those without HELLP syndrome (Group 2) according to the aformentioned HELLP syndrome parameters. Both groups were assessed in terms of some perinatal complications such as preterm delivery, IUGR, abruptio placenta and fetal and some biochemical and hematologic parameters. Results: Between January 2015 and July 2018, a total of 8730 deliveries were made in our hospital. 154 (1.7%) women had got a diagnosis of severe preeclampsia without HELLP syndrome (Group 1). 38 (0.4%) had severe preeclampsia with HELLP (Group 2). In Group 1, 22 cases had IUGR (14.2%), 8 had abruptio placenta (5.2%), 50 had preterm delivery (32.4%). In Group 2, 7 cases had IUGR (18.4%), 3 had abruptio placenta (7.8%) and 10 (26.3%) had preterm delivery. There was no statistically significant difference between groups in terms of all three parameters. Although there were no significant differences, fetal mortality (1.2% vs 5.2%) and cesarean rates (77.2% vs 86.8%) were higher in Group 2. We detected significance in terms of acute renal failure and disseminated intravascular coagulopathy rates, need for invasive care and blood product transfusion between groups. All were higher in latter. Conclusion: Severe preeclampsia, particularly ones with HELLP, are related to high perinatal complications and increased maternal mortality and morbidity, it is necessary to terminate such pregnancies and to provide appropriate supportive therapy in time.