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Pregnancy outcome of hemolysis elevated liver Enzymes and low platelate count syndrome at teaching hospital, Addis Ababa, Ethiopia
Background: HELLP syndrome is a life-threating complication in pregnancy that occur in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia/eclampsia. It is associated with increased rate of both maternal and perinatal complications.
Objectives: The aim of this study was to assess maternal and perinatal outcome of HELLP syndrome at teaching Hospital in Ethiopia.
Methods: This was a 2-year retrospective based chart review of all women diagnosed with HELLP syndrome and delivered at Saint Paul’s Hospital Millennium Medical College in obstetrics and gynecology department in A.A, Ethiopia. Data entry and analysis was made using SPSS version 23 software. Frequency and percentages were calculated and presented in tables. Bivariate and multivariate analysis were used to see association and control confounding variables. Ethical clearance was obtained from the IRB of SPHMMC.
Results: There were 20,111 deliveries during the study period, of which 0.57% (115) of the mothers developed HELLP Syndrome. Among these ,101 women fulfilling the inclusion criteria were included and their records were analyzed retrospectively. 36.6% of the cases were in the age group of 27-31 years. Majority 60.4% of the cases were primiparous while 39.6% of them were multiparous. Most of the mothers,92% were referred cases and 63.4% were from Addis Ababa. 89.1% cases occurred during antepartum and 10.9% after delivery. The mean gestational age was 33.40 ± 4.474 wks. 68% had Partial and 32% of them had complete HELLP syndrome. Caesarean and vaginal delivery rate were 47.5% and 52.5% respectively. There was no maternal death. 30.7% (31/101) of the mothers developed maternal complications. Acute kidney injury was the most frequent maternal complication 24.8%, followed by pulmonary Oedema 11.9%. Mothers with complete HELLP syndrome and when it arises in postpartum period were found to have significant influence on maternal morbidity with p -value of 0.03 for both, AOR= 0.223 (95% CI= 0.018-0.863) and AOR =0.360 (95% CI= 0.144-0.901) respectively. The were 108 infants delivered :70.4% were preterm while 29.6% were term deliveries. Twenty-three (21.3%) babies were IUGR. 78.7 % were born alive,12% were intrapartum deaths and 9.3% were still births. 9.3% were ENDs making over all overall perinatal mortality of 30.6%(33/108).
Conclusion: The incidence of HELLP syndrome in this study was low with significant maternal morbidity and perinatal complications. It needs further prospective study with large sample size in country level....