HELLP syndrome in pregnancies below 26th week

Abstract

Objective: To test the hypothesis that HELLP syndrome may be more likely to develop earlier, if a pregnant woman has aPL antibodies, and to observe clinical and laboratory factors preceding the occurrence of HELLP syndrome. Materials and methods: The study consisted in retrospective analysis, with updated verification, of HELLP syndrome in pregnancies below 26th week in our clinic in the years 1992–2010. Results: HELLP syndrome, if it occurred before the 26th week, occurred only in women with preeclampsia superimposed on chronic hypertension and in women with aPL antibodies. HELLP syndrome with aPL antibodies occurred with low level of platelets (mean 35.5 × 10⁹/L), lower level of AT III (mean 71.3%), lymphopenia, higher CRP (mean 9.1) and pale infarct of placenta (100%). The occurrence of HELLP syndrome was always preceded by surges in blood pressure resistant to antihypertensive drugs. Conclusion: HELLP syndrome in early pregnancy may indicate the presence of aPL antibodies. It may also be a clinical symptom of APS. A surge in blood pressure is a clinical forerunner of the coming HELLP syndrome. HELLP syndrome in women with APS is characterized by low level of platelets.

Keywords::

• aPL antibodies
• APS
• CAPS
• HELLP syndrome
• hypertension

Acknowledgement

Andrzej Karmowski, MD, Professor: I had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Declaration of interest: The authors report no conflicts of interest.