Characterization of Hellp syndrome as a severe complication of preeclampsia A single-center observational study.

Abstract

Introduction: The objective of this present study was to characterize women with HELLP syndrome as a complication of severe preeclampsia in a public reference center in Guayaquil, Ecuador, with the hypothesis that thrombocytopenia is the most frequent clinical manifestation in patients with this syndrome.

Methods: This observational study was conducted at Hospital Matilde Hidalgo de Procel in Guayaquil, Ecuador, from 2020 to 2022. Pregnant women with preeclampsia and HELLP syndrome were included. Variables such as age, gestational age, comorbidities, pregnancy history, presence of hypertensive situations, hepatic transaminases, platelet count, length of hospitalization, type of delivery, near misses, and maternal mortality were analyzed. The sample was probabilistic, and descriptive statistics were used.

Results: Of 1913 patients with severe preeclampsia, the incidence of HELLP syndrome was 76 cases (4.0%, 95%CI 3.1%- 4.8%). The population was predominantly Afro-Ecuadorian. The prevalence of gestational age was 28 weeks. Predominant comorbidities were type 2 diabetes mellitus and hypertension. All cases presented elevations in the enzymes TGO, TGP, and bilirubin. 90% of cases demonstrated a decrease in platelet count. The majority of patients required termination of pregnancy. Patients received treatment with corticosteroids and antihypertensive drugs.

Conclusions: This study shows that HELLP syndrome is a significant complication of severe preeclampsia, affecting mainly women of childbearing age with diverse comorbidities and coming from different geographic areas.