Hellp syndrome (hemolyisis, elevated liver enzymes and low platelets) : a review of the pathophysiology, diagnosis, management and anaesthetic considerations
Other Title(s)
متلازمة HELIP ( انحلال كريات الدم الحمراء و ارتفاع خمائر الكبد و انخفاض الصفيحات الدموية ) دراسة مرجعية للتشخيص و التشريح المرضي و العلاج و طرق التخدير
Source
Journal of the Arab Board of Health Specializations
Issue
Vol. 4, Issue 4 (31 Dec. 2002), pp.30-38, 9 p.
Publisher
The Arab Board of Health Specializations
Publication Date
2002-12-31
Country of Publication
Syria
No. of Pages
9
Main Subjects
Abstract EN
HELLP syndrome (hemolyisis, elevated liver enzymes, low platelets) is associated with poor maternal and fetal outcomes.
Maternal mortality has been estimated as high as 24%.
These patients are also at greater risks from pulmonary edema, adult respiratory distress syndrome (ARDS), abruptio placentae, disseminated intravascular coagulopathy (DIC), ruptured liver hematomas, and acute renal failure (ARF).
Perinatal mortality is equally high ranging from 79 to 367 per 1000 live births, and neonatal complications correlate with the severity of maternal disease.
Many clinicians view HELLP syndrome as an entity of preeclampsia, and with the varied symptomatology, the initial diagnosis may be obscured.
Prodromal signs include: 1) right upper quadrant and/or epigastric pain, 2) nausea and vomiting, 3) headache, 4) visual changes, 5) increased tendency to bleed from minor trauma, 6) jaundice, 7) diarrhea and 8) shoulder or neck pain.
Prior to delivery, aggressive obstetric management is directed toward stabilization of the affected organ systems and timely interruption of the pregnancy in the early phase of accelerated disease progression.
Definitive therapy is delivery.
Parturients with HELLP syndrome are often critically ill; their infants are frequently premature and compromised.
Management criteria should include a multidisciplinary approach in a tertiary care centre.
The obstetric anaesthesia personnel should perform a thorough preanaesthetic evaluation and have considerable knowledge of the pathophysiology of this syndrome.
Unless significant coagulopathy is diagnosed, epidural anaesthesia is preferred over general anaesthesia, and spinal anaesthesia is perhaps contraindicated.
American Psychological Association (APA)
Rajab, Khalil Ibrahim& Skerman, Jonathan H.& Isa, Abd Allah A.. 2002. Hellp syndrome (hemolyisis, elevated liver enzymes and low platelets) : a review of the pathophysiology, diagnosis, management and anaesthetic considerations. Journal of the Arab Board of Health Specializations،Vol. 4, no. 4, pp.30-38.
https://search.emarefa.net/detail/BIM-148240
Modern Language Association (MLA)
Rajab, Khalil Ibrahim…[et al.]. Hellp syndrome (hemolyisis, elevated liver enzymes and low platelets) : a review of the pathophysiology, diagnosis, management and anaesthetic considerations. Journal of the Arab Board of Health Specializations Vol. 4, no. 4(December 2002), pp.30-38.
https://search.emarefa.net/detail/BIM-148240
American Medical Association (AMA)
Rajab, Khalil Ibrahim& Skerman, Jonathan H.& Isa, Abd Allah A.. Hellp syndrome (hemolyisis, elevated liver enzymes and low platelets) : a review of the pathophysiology, diagnosis, management and anaesthetic considerations. Journal of the Arab Board of Health Specializations. 2002. Vol. 4, no. 4, pp.30-38.
https://search.emarefa.net/detail/BIM-148240
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 37-38
Record ID
BIM-148240