Comparative analysis of maternal and fetal outcomes in preeclampsia with and without HELLP syndrome in Uzbek women: a retrospective cohort study
Abstract
We conducted the current study with the aim of comparing maternal and fetal results in preeclampsia with and without HELLP syndrome among Uzbek women. It is a historical cohort study on 615 pregnant patients with preeclampsia who were referred to a medical center over a 5-year period. Of these, 78 patients (12.7%) belonged to the HELLP group and 537 patients (87.3%) belonged to the preeclampsia without HELLP group. The results from the study revealed lower gestational age at diagnosis in the HELLP group (31.2 vs. 36.1 weeks). The HELLP group had higher rates of severe complications such as eclampsia (14.1 vs. 2.8%), acute renal failure (1.23 vs. 1.4%), and intensive care unit admission (1.32 vs. 3.4%) compared to maternal outcomes. With respect to fetal outcomes, preterm birth at less than 32 weeks (32.1% vs. 2.5%) and low birth weight (87.2% vs. 39.1%) were increased in the HELLP group. Perinatal mortality was significantly greater in the HELLP group (192.3/1000 vs. 33.5/1000). Multivariate analysis also defined epigastric pain, platelet count <100, and AST >150 as independent predictors for HELLP. These findings strongly suggest that HELLP syndrome is a singular and much more dangerous clinical condition than uncomplicated preeclampsia and needs to be diagnosed early and treated intensively in order to improve the outcomes of both the mother and the fetus.