Lupus Anticoagulant and HELLP Syndrome Complicated by Placental Abruption, Hepatic, Dermal and Adrenal Infarction

1995 ◽  
Vol 35 (2) ◽  
pp. 215-217 ◽  
Author(s):  
M. Ilbery ◽  
A.R. Jones ◽  
J. Sampson
Keyword(s):  
Hellp Syndrome ◽  
Lupus Anticoagulant ◽  
Placental Abruption ◽  
Adrenal Infarction

scholarly journals Síndrome HELLP com descolamento placentário e óbito fetal: relato de caso

2017 ◽  
Vol 4 (3) ◽  
pp. 34
Author(s):  
Carlos Alberto Rodrigues Junior ◽  
Fellipe Camargo Ferreira Dias ◽  
Flávia Da Silva Oliveira ◽  
Gustavo Santos Sousa ◽  
Fábio Roberto Ruiz de Moraes ◽  
...  
Keyword(s):  
Health Status ◽  
Hellp Syndrome ◽  
Fetal Death ◽  
Placental Abruption ◽  
Antihypertensive Drugs ◽  
Good Health ◽  
Pressure Control ◽  
Elevated Liver Enzymes ◽  
Intravenous Hydration ◽  
Fluid Losses

The HELLP syndrome – defined as haemolysis, elevated liver enzymes and thrombocytopenia – consists of an advanced stage of preeclampsia (PE), which can affect 0.6% of pregnancies and 4-12% of patients with severe PE. Being responsible for elevated maternal and perinatal mortality rates, it can present with general malaise, epigastralgia, right hypochondrium pain, nausea and vomits, headache, scotomas, associated with hypertension and proteinuria. Woman, 19 years old, primigest, admitted with 29 weeks of gestational age presenting with arterial hypertension (160/120 mmHg), headache, scotomas, nausea and vomits. She showed regular health status, pallid, closed, anterior and soft cervix, with no fluid losses, and inaudible fetal heart rate on the sonar. She was stabilized with intravenous hydration and antihypertensive drugs, the ultrasonography showed placental abruption and fetal death. An uneventfully caesarean operation was performed under general anaesthesia. Due to the low haemoglobin, haematocrit and platelet levels, she received blood transfusion, progressing with clinical and laboratory improvement. The pressure control was met by the use of methyldopa, nifedipine and pindolol, and she was discharged with a good health status at the 10th day of hospitalization, with scheduled return for reassessment.   Keywords: HELLP syndrome, severe preeclampsia, fetal death, placental abruption. A síndrome HELLP – definida por hemólise, enzimas hepáticas elevadas e plaquetopenia – consiste em estágio avançado de pré-eclâmpsia (PE), podendo afetar 0,6% das gestações e 4-12% das pacientes com PE grave. Responsável por elevados índices de mortalidade materna e perinatal, pode se apresentar com mal estar geral, epigastralgia, dor em hipocôndrio direito, náuseas ou vômitos, cefaleia, escotomas, assoaciado a quadro hipertensivo e proteinúria. Mulher de 19 anos, primigesta, admitida com 29 semanas de idade gestacional com quadro de hipertensão arterial (160/120 mmHg), cefaleia, escotomas, náuseas e vômitos. Apresentava regular estado geral, hipocorada, colo uterino fechado, anterior, amolecido e sem perdas e batimento cardiofetal inaudível ao sonar. Estabilizada com hidratação venosa e anti-hipertensivos, foi realizada ultrassonografia que evidenciou descolamento prematuro de placenta e óbito fetal. Realizada cesariana sob anestesia geral sem intercorrências. Devido a baixos níveis de hemoglobina, hematócrito e plaquetas, foi hemotransfundida, apresentando melhora clínica e laboratorial. O controle pressórico foi atingido com uso de metildopa, nifedipina e pindolol, recebendo alta em bom estado geral no 10º dia de internação hospitalar com programação de retorno para reavaliação. Palavras-chave: Síndrome HELLP, Pré-eclâmpsia grave, óbito fetal, descolamento placentário.

scholarly journals Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana

2016 ◽  
Vol 4 (1) ◽  
pp. 102-106
Author(s):  
Eriseida Ndoni ◽  
Redi Hoxhallari ◽  
Astrit Bimbashi
Keyword(s):  
Renal Failure ◽  
Caesarean Section ◽  
Pulmonary Edema ◽  
Postpartum Hemorrhage ◽  
Hellp Syndrome ◽  
Placental Abruption ◽  
Severe Preeclampsia ◽  
University Hospital ◽  
Multisystem Disorder ◽  
Maternal Complications

BACKGROUND: Preeclampsia is a hypertensive multisystem disorder of pregnancy that complicates up to 10% of pregnancies worldwide and is one of the leading causes of maternal and perinatal morbidity and mortality.AIM: To evaluate maternal complications associated with severe preeclampsia.METHODS: This is a retrospective cross-sectional study conducted in the UHOG “Koço Gliozheni”, in Tirana. Primary outcomes evaluated: maternal death, eclampsia, stroke, HELLP syndrome, and pulmonary edema. Secondary outcomes: renal failure, admission in ICU, caesarean section, placental abruption, and postpartum hemorrhage. Fisher’s exact test and Chi-squared test were used as statistical methods. RESULTS: In women with severe preeclampsia we found higher rates of complications comparing to the group with preeclampsia. Eclampsia (1.5% vs. 7.1%, P < 0.001), HELLP syndrome (2.4% vs. 11.0%; P < 0.001), stroke (0.5% vs 1.9%, P = 0.105) pulmonary edema (0.25% vs. 1.3%, P = 0.0035), renal failure (0.9% vs. 2.6%, P = 0.107), admission in ICU (19.5% vs. 71.4%, P = 0.007), caesarean section rates (55.5% vs. 77%, P = 0.508), placental abruption (4.3% vs. 7.8%, P = 0.103) and severe postpartum hemorrhage (3.2% vs. 3.9%, P = 0.628). CONCLUSION: Severe preeclampsia is associated with high rates of maternal severe morbidity and early diagnosis and timely intervention can prevent life treating complications.

The Association Between Antiphospholipid Antibodies and Adverse Pregnancy Outcomes: A Metaanalysis.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1819-1819
Author(s):  
Karim Abou-Nassar ◽  
Marc Carrier ◽  
Marc Rodger
Keyword(s):  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Placental Abruption ◽  
Fetal Loss ◽  
Anticardiolipin Antibodies ◽  
Adverse Pregnancy Outcomes ◽  
Clinical Criteria ◽  
Adverse Pregnancy

Abstract BACKGROUND: The Sapporo criteria for the diagnosis of the antiphospholipid syndrome (APS) are based on the presence of antiphospholipid antibodies (APLA) and clinical criteria. Although pre-eclampsia, intra-uterine growth restriction (IUGR), late fetal loss and placental abruption, collectively termed “placenta mediated complications”, are recognized as clinical criteria for the APS, their association with APLA remains controversial. OBJECTIVE: This review was conducted to evaluate the association between APLA (anticardiolipin antibodies, lupus anticoagulant, anti B2 glycoprotein 1 antibodies) and placenta mediated complications in untreated women without autoimmune diseases. METHODS: We performed a systematic review of published case-control, cohort and cross sectional studies using MEDLINE (1975 to October week 2 2007), EMBASE 16 (1980 to 2007 week 42) and all EBM Reviews (3rd quarter of 2007). For eligible studies, the rates of adverse pregnancy outcomes were compared between patients with and without specific APLA. Pooled odds ratios with 95% CI were generated using random-effects models. RESULTS: Our search strategy identified 1204 potentially relevant studies. Twenty five were included in the final analysis. Results are outlined in table 1. CONCLUSION: The association between various APLA and pregnancy complications is for the most part weak and inconsistent. There is currently insufficient data to support a significant link between anti-B2 glycoprotein 1 antibodies and pregnancy morbidity. Caution should be used when establishing a diagnosis of APS based on the presence of any APLA, particularly anti-B2 glycoprotein 1 antibodies, in the setting of late pregnancy complications. Table 1 Association Between APLA and Adverse Pregnancy Outcomes Pre-eclampsia OR (95%CI) # studies / participants IUGR OR (95%CI) # studies / participants Placental abruption OR (95%CI) # studies / participants Late fetal loss OR (95%CI) # studies / participants LA: Lupus anticoagulant; aCL: Anticardiolipin antibodies; Anti-B2 GP1 antibodies: Anti-B2 glycoprotein 1 antibodies italic characters indicate statistically significant associations LA 2.88 (1.42, 5.87)&#x2028; 11 / 6085 3.51 (1.38, 8.93)&#x2028; 4 / 3232 0.78 (0.13, 4.80)&#x2028; 2 / 226 3.56 (0.12, 106.05)&#x2028; 3 / 3870 aCL (IgG/IgM) 1.71 (1.09, 2.70)&#x2028; 21 / 9722 2.31 (0.74, 7.17)&#x2028; 6 / 5753 1.35 (0.45, 4.02)&#x2028; 4 / 1274 3.86 (1.14, 13.07)&#x2028; 7 / 5963 aCL IgG 1.65 (0.84, 3.22)&#x2028; 15 / 3627 6.16 (2.50, 15.18)&#x2028; 2 / 1006 1.87 (0.21, 16.83)&#x2028; 2 / 500 10.06 (0.88, 114.96)&#x2028; 2 / 1006 aCL IgM 1.36 (0.93, 1.97)&#x2028; 13 / 5397 0.75 (0.19, 2.93)&#x2028; 2 / 3002 0.96 (0.24, 3.85)&#x2028; 2 / 500 1.37 (0.42, 4.46)&#x2028; 3 / 3212 anti- B2GP1 (IgG/IgM) 2.97 (0.47, 18.69)&#x2028; 4 / 2225 20.03 (4.59, 87.43)&#x2028; 1 / 1108 2.64 (0.14, 50.63)&#x2028; 1 / 510 6.74 (0.24, 191.23)&#x2028; 3 / 1828 anti- B2GP1 IgG 0.87 (0.38, 2.01)&#x2028; 2 / 607 N/A&#x2028; 0 / 0 N/A&#x2028; 0 / 0 0.52 (0.02, 11.02)&#x2028; 1 / 212 anti- B2GP1 IgM 0.37 (0.16, 0.85)&#x2028; 1 / 400 N/A&#x2028; 0 / 0 N/A&#x2028; 0 / 0 1.32 (0.24, 7.42)&#x2028; 1 / 210

scholarly journals HELLP Syndrome as a Potential Cause of False Positive Lupus Anticoagulant Testing

2017 ◽  
Vol 147 (suppl_2) ◽  
pp. S168-S168
Author(s):  
Zhen Mei ◽  
Krzysztof Mikrut ◽  
Jonathan Miller
Keyword(s):  
False Positive ◽  
Hellp Syndrome ◽  
Lupus Anticoagulant

Placental abruption as a trigger of DIC in women with HELLP syndrome: a population-based study

2020 ◽  
pp. 1-11
Author(s):  
Rachel Gomez-Tolub ◽  
Anat Rabinovich ◽  
Eric Kachko ◽  
Neta Benshalom-Tirosh ◽  
Dan Tirosh ◽  
...  
Keyword(s):  
Hellp Syndrome ◽  
Placental Abruption ◽  
Population Based ◽  
Population Based Study

scholarly journals Maternal Outcome in Women with Preeclampsia

2021 ◽  
Vol 15 (7) ◽  
pp. 1769-1771
Author(s):  
Uzma Siddique ◽  
Syeda Khalida Naeem ◽  
Bushra Begum Ramejo ◽  
Aesha Sadaf Rizwan ◽  
Moniza Imran ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Gestational Age ◽  
Hellp Syndrome ◽  
Placental Abruption ◽  
Maternal Outcomes ◽  
Blood Picture ◽  
Maternal Complications ◽  
Medical College

Aim: To determine the maternal outcomes in women presented with severe pre-eclampsia. Study Design: Prospective/Observational Place and Duration: Obs & Gynae department of Akhtar Saeed Medical and Dental College and Hospital, Lahore and Kausar hospital/Khairpur Medical College, Khairpur Mir’s Methods: Total 100 patients with ages 18 to 45 years presented with pre-eclampsia were included in this study. Patients detailed demographic including age, parity, gestational age, and body mass index were recorded after taking written consent. Patients complete blood picture was examined. Complications associated with preeclampsia were examined. Data was analyzed by SPSS 23.0. Results: Out of 100 patients 23 (23%) were ages <20 years, 42 (42%) were ages 20 to 30 years, 30 (30%) were ages 31 to 40 years and 5 (5%) were ages above 40 years. 41 (41%) were primigravida while 59 (59%) were multigravida. Mean gestational age was 34.11±3.88 weeks. HELLP syndrome found in 21 (21%) patients, 11 (11%) patients had eclampsia, and 16 (16%) patients had placental abruption, coagulopathy found in 4 (4%) patients, 3 (3%) patients developed acute renal failure and 2 (2%) patients were died. Conclusion: It is concluded that pre-eclampsia is highly associated with major maternal complications such as HELLP syndrome, eclampsia, placental abruption and maternal mortality. Keywords: Pre-eclampsia, HELLP Syndrome, Placental Abruption, Eclampsia, Mortality

scholarly journals Pancreatic and Colonic Abscess Formation Secondary to HELLP Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
James M. O’Brien ◽  
Nicole Pursell ◽  
Fred Fumia
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Hellp Syndrome ◽  
Placental Abruption ◽  
Organ System ◽  
Elevated Blood ◽  
Vascular Changes ◽  
Quadrant Pain ◽  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Coagulopathy

Preeclampsia and the variant HELLP syndrome are systemic conditions associated with vascular changes resulting in vasoconstriction. Most commonly, patients present with elevated blood pressure and proteinuria, with a background of complaints such as headache, scotoma, and right upper quadrant pain. The systemic vascular changes experienced can target any organ system, oftentimes with more than one organ system being involved. We present the case of a patient admitted with HELLP syndrome who subsequently developed multisystem organ dysfunction, including placental abruption, disseminated intravascular coagulopathy, acute renal failure, colitis, abdominal ascites, pancreatitis, and the development of pancreatic and colonic abscesses.

Factor XII Determinations in the Presence and Absence of Phospholipid Antibodies

1998 ◽  
Vol 79 (01) ◽  
pp. 87-90 ◽  
Author(s):  
D. W. Jones ◽  
M. Winter ◽  
M. J. Gallimore
Keyword(s):  
Lower Limit ◽  
Lupus Anticoagulant ◽  
Factor Xii ◽  
Chromogenic Substrate ◽  
Plasma Samples ◽  
Presence And Absence ◽  
Lower Limit Of Normal

SummaryFactor XII (FXII) levels were determined in plasma samples from 29 normal donors, 10 patients with inherited FXII deficiency (all lupus anticoagulant [LA] negative) and 67 LA positive patients, using clotting (FXIIct), chromogenic substrate (FXIIcs) and immunochemical (FXIIag) assays. Excellent correlations were obtained in the three FXII assays with the LA negative samples and between the FXIIcs and FXIIag assays in the LA positive samples. Correlations between both the FXIIcs and FXIIag with FXIIct in the LA positive patients were poor. Of 67 LA positive samples studied, 25 (37.3%) showed lower values in the FXIIct assay; 13 (19.4%) of these patients were pseudo FXII deficient with values of FXII below the lower limit of normal.These results indicate that a diagnosis of FXII deficiency can be made inappropriately in the presence of phospholipid antibodies and that such a diagnosis should not be made by FXIIct assay alone.

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