HELLP综合征14例临床分析

Clinical analysis of 14 cases of HELLP syndrome

目的探讨产科并发症HELLP综合征的母儿预后。方法回顾性分析研究14例HELLP综合征的患者妊娠结局和围产儿预后。结果14例中12例发生在产前,2例发生在产后,平均孕龄为32·5周,孕妇的严重并发症包括:急性肾衰、DIC、肺水肿、严重腹水和胎盘早剥等。其中8例需要输血或血液制品,12例采用剖宫产结束分娩。围产儿死亡5例,主要与胎盘早剥有关,另外胎儿宫内窘迫及早产也是重要原因。结论HELLP综合征是一种严重的产科并发症,其高的母婴并发症和病死率要求我们对有妊娠高血压疾病的患者进行密切随访和治疗,一旦确诊为HELLP综合征应转入中心级以上医院进行治疗,尽快终止妊娠。

Objective To investigate the maternal and perinatal outcomes of pregnancies complicated with HELLP syndrome. Methods Fourteen cases of HELLP syndrome were retrospectively analyzed on maternal and pefinatal outcomes. Results In 14 case of women with HELLP syndrome, 12 presented antepartum HELLP and 2 postpartum. Mean gestational age at delivery was 32.5 weeks. Severe maternal complications included acute renal failure, disseminated intravascular coagulation, abruption placenta, pulmonary edema and severe ascites, et al. Eight patients required transfusions with blood or blood products and 12 women underwent cesarean section. Five perinatal deaths were related to abrupfion placenta, intrauterine asphyxia and extreme premature delivery. Conclusions HELLP syndrome is a severe obstetric complication. The high maternal and perinatal mortality and morbidity of mother and baby requires close maternal - fatal surveillance and timely management. Once the diagnosis was made, the patients should be sent to the central hospital and termination of the pregnancy as soon as possible would be helpful for the prognosis.