Upgrading ICU management of several pre-eclampsia and hellp syndrome

Abstract EN

Twenty-one patients with severe pre-eclampsia, eclampsia and HELLP syndrome were treated in our ICU since January 2000 - Jan.

2001.

The HELLP syndrome is defined as pre-eclampsia complicated by hemolysis, elevated liver enzymes and low platelets, HELLP syndrome was found in 9 out of 21 pre-eclamptic and eclamptic women (42, 86%), greater incidence of eclamptic crisis 62.5%, on admission the mean platelets count 57 + 32.25 xl09/L, SGOT 299.3+394, SGPT 386.1+367.

Management by using antihypertensive, sedatives, antieclamptic measures with Magnesium sulphate or phenytion, blood and blood products transfusion to correct coagulopathy and thrombocytopenia, ventilation in 5 cases, haemodialysis in one case for 4 settings, peritoneal dialysis in 2 patients, dopamine infusion 1-3 ug/kg/min in 11 cases.

The mortality rate was 2 patients (9.5%) who had HELLP syndrome with development of ARDS, DIC, renal, hepatic, cardiac failure in spite of aggressive management.

Conclusion : Pre-eclampsia, eclampsia with HELLP syndrome should be suspected when platelet count less than 100 X 109/L for early diagnosis, termination of pregnancy, aggressive management in ICU to reduce morbidity and mortality.