Using case reports to determine when liver bleeding occurs during disease progression in HELLP syndrome

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• 作者：Marie Darby ; James N. Martin Jr ; Sarah Q. Mitchell ; Michelle Y. Owens ; Kedra Wallace
• 关键词：Dexamethasone ; Hemolysis ; elevated liver enzymes ; low platelets ; Liver hematoma ; Liver rupture
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：123
• 期：1
• 页码：7-9
• 全文大小：165 K

文摘

class=""h4"">Background

Hepatic hemorrhage occurs in less than 5 % of patients with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome but it is a profound cause of maternal/perinatal morbidity and mortality.

class=""h4"">Objectives

To determine when liver bleeding occurs during the development of HELLP syndrome.

class=""h4"">Search strategy

The English literature was searched for all reports of HELLP syndrome associated with liver bleeding.

class=""h4"">Selection criteria

Eighty-seven case summaries of liver bleeding in the setting of HELLP syndrome were included. The standard definition of HELLP syndrome was used with expansion into the Mississippi classification system, supplemented by patients with partial HELLP syndrome.

class=""h4"">Data collection and analysis

Demographic and clinical data were collected and recorded in an Excel database.

class=""h4"">Main results

Liver bleeding was detected in 18 (20.7 % ) patients with class 1 HELLP syndrome, 24 (27.6 % ) with class 2 HELLP syndrome, and 12 (13.8 % ) with class 3 or partial HELLP syndrome. In 33 (37.9 % ) patients, the exact class of HELLP syndrome at the time liver bleeding was detected could not be determined from the published descriptions.

class=""h4"">Conclusions

Liver bleeding can occur early during HELLP syndrome development, not only in patients with advanced, class 1 illness.