TITLE:
Clinical Presentation, Management and Materno-Fetal Outcome of Patients with HELLP Syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital
AUTHORS:
Nzometia Crysantus Yimlefack, Foumane Pascal, Dohbit Julius Sama, Kenn Chi Ndi, Daniel Tarh Ketchen, Claude Hector Mbia, Robinson Enow Mbu
KEYWORDS:
HELLP Syndrome, Clinical Presentation, Management, Maternal and Fetal Outcomes
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.8,
August
30,
2023
ABSTRACT: Background: HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a common complication of severe
preeclampsia, with a high maternal and perinatal mortality rate. Data on
HELLP syndrome is scanty in our setting. We sought to study the clinical
presentation, management, and materno-fetal outcome of patients with HELLP
syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital (YGOPH). Methods: This was a cross-sectional, analytical study with a retrospective data
collection of patients, diagnosed with HELLP syndrome at the YGOPH between 1st
January 2020 and 31st July 2021. Data were analyzed using the software R
version 4.0.2. Results are presented as mean ± standard deviation, frequencies and percentages. P values Results: Of 254
cases of severe preeclampsia, 17 developed HELLP syndrome, giving us a
frequency of 6.7%. One patient who presented with hepatitis B was excluded. The
mean age was 27.19 ± 6.44 years. Most patients
(56.3%) had poor follow up during antenatal contacts. The most common symptom
was headache (93.8%). Most cases (56.3%) were diagnosed during post-partum,
prepartum (25.0%), and per partum (18.8%). Obstetrical management was done by
cesarean section (62.5%) and vaginal delivery (37.5%). Post-partum management
of HELLP syndrome consisted of antihypertensive medication, anticonvulsants,
sedatives, transfusion of blood and blood products, and fluid resuscitation. Of
the 50% of patients who presented with acute kidney injury, only 12.5% (1) were
referred for dialysis. Over 50% of our study participants presented severe
complications after delivery, but 43.8% recovered, while 56.2% finally died.
The fetal outcome was: still birth (31.2%), intra-uterine growth restriction/low birth weight (12.5%), term
delivery (≥37 weeks) (31.3%), and preterm deliveries (Conclusion: Although rare, HELLP syndrome
exists in our setting. Proper management in appropriate centers is key to
improving maternal and fetal outcomes.