Is HELLP Syndrome that Occurs After the 34th Week of Pregnancy More Risky for Mothers?

INTRODUCTION: We compare patients with hemolysis, elevated liver enzyme levels, and low platelet (HELLP) levels syndrome developing before and after 34 weeks of pregnancy in terms of demographic data, laboratory values, treatments, and maternal and fetal complications.
METHODS: This retrospective descriptive study included 42 patients admitted to an intensive care unit (ICU) over 3 years. The patients were divided into two groups: Those who developed the syndrome at ≤34 weeks (Group I, n=23) and at ˃34 weeks (Group II, n=19) of pregnancy.
RESULTS: The HELLP syndrome rate was 7.08% (42/593). The mean ICU stay was 3.83±4.04 days and the mean hospital stay 7.49±5.71 days. The mean hemoglobin level and hematocrit of Group II patients were significantly lower than those of Group I patients (p=0.019; p=0.025); the aspartate aminotransferase (AST) level and prothrombin time (PT) of the former patients were significantly higher (p=0.047; p=0.001), as was the volume of erythrocyte suspension (ES) required (p=0.01). Most patients with hypertension and pre-eclampsia were in Group I; all patients lacking hypertension and pre-eclampsia were in Group II (p=0.03; p=0.03).
DISCUSSION AND CONCLUSION: Patients with HELLP syndrome developing after 34 weeks of pregnancy had a lower hemoglobin level and hematocrit; a higher AST level and PT; and required more ES. HELLP syndrome developing in the absence of hypertension and proteinuria was especially prevalent in women who were more than 34 weeks’ pregnant.