Platelet Values Regarding Maternal-Fetal Outcomes In Hemolysis, Elevated Liver Enzymes, Low Platelets (HELLP) Syndrome

Objective: To analyze the consequences of platelet counts < 100 000/mu L in HELLP syndrome with AST 3 70 U/L considering laboratory parameters and maternal-fetal well-being. Materials and Methods: Twenty-seven women with HELLP syndrome (AST 3 70 U/L and platelet count < 100 000/mu L) were included and divided into two: Group 1 (n=15) with platelet counts < 100 000/mu L and Group 2 (n=12) with 3 100 000/mu L. Groups were compared for laboratory data and maternal-perinatal outcome, using Mann-Whitney U-test and chi-square tests. Results: Hematological complications were the most frequent (55.6%) morbidity in the overall study population. Requirements for blood and/or blood product transfusions were higher in Group 1 (73.3%) compared with Group 2 patients (33.3%, p=0.03). Premature rupture of membrane was more frequent in Group 2 but it did not reach statistical significance (p=0.07). Also oligohydramnios and neonatal sepsis were more frequent in Group 2 (p=0.03 and p=0.01, respectively), than those in Group 1. Conclusion: Decreased platelet values in HELLP syndrome with plasma AST 3 70 U/L is related to maternal hematological morbidity. More frequent premature rupture of membranes may be the reason of increased oligohydramnios and neonatal sepsis rates in HELLP syndrome with platelet count > 100 000 /mu L. However, other fetal and maternal complications seem to be unrelated with the severity of thrombocytopenia.