Maternal complications of fetal triploidy: a case report

2020 ◽  
Vol 13 (10) ◽  
pp. e236950
Author(s):  
Sarah Wali ◽  
Marianne Wild
Keyword(s):  
Liver Enzymes ◽  
Late Onset ◽  
Ovarian Hyperstimulation ◽  
Second Trimester ◽  
Maternal Complications ◽  
Medical Termination ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Early Onset Preeclampsia

A 32-year-old woman underwent a medical termination in the second trimester of a spontaneously conceived triploid pregnancy after developing early-onset preeclampsia with subsequent haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Placental histology was normal (non-molar) and unusually, she developed ovarian hyperstimulation syndrome (OHSS) 4 weeks later. She was managed conservatively following multidisciplinary team input to exclude malignant pathology. The rarity of late-onset spontaneous OHSS could have resulted in inappropriate surgical management. In the absence of supportive treatment there is also a risk of the condition progressing to a critical stage. Follow-up ultrasonography after termination of pregnancy should be considered for women with evidence of ovarian hyperstimulation, particularly if other risk factors for OHSS are present. Delayed-onset OHSS should be considered in women presenting with bilateral cystic ovarian enlargement after triploid pregnancy.

scholarly journals Fetomaternal outcome in pregnancy with HELLP syndrome

2020 ◽  
Vol 9 (7) ◽  
pp. 2860
Author(s):  
Prachi M. Shelat ◽  
Rupa C. Vyas ◽  
Sapana R. Shah ◽  
Naimish D. Nathwani
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Care Center ◽  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Intrauterine Death ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Background: HELLP Syndrome is a serious complication of pregnancy induced hypertensive disorders. It is defined as a triad of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Objectives of this study was to find out incidence of HELLP syndrome in pre-eclampsia, eclampsia and its overall incidence. To analyse the clinical profile of HELLP syndrome. To study maternal and perinatal outcome including morbidity and mortality.Methods: A retrospective study was conducted from July 2017 to September 2019 at a tertiary care center with inclusion criteria of abnormal peripheral blood smear, elevated liver enzymes (LDH, aspartate aminotransferase), and low platelet count.Results: HELLP syndrome was more common in younger age group (45%) and in primigravida (52.5%). Most of the patients presented at >36 weeks of gestation (40%) and most of the patients delivered by caesarean section (67.5%). Maternal complications were acute renal failure (27.5%), DIC (22.5%), maternal mortality (7.5%). Neonatal complications associated were intrauterine death (27.5%), prematurity (25%) and intrauterine growth retardation (15%).Conclusions: Thus, HELLP syndrome requires an early diagnosis and early initiation of treatment at tertiary care center with all the medical facilities available.

scholarly journals Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?

2019 ◽  
Vol 57 (9) ◽  
pp. 1339-1348 ◽  
Author(s):  
Holger Stepan ◽  
Martin Hund ◽  
Peter Dilba ◽  
Johanna Sillman ◽  
Dietmar Schlembach
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Late Onset ◽  
Correlation Coefficients ◽  
Serum Samples ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio ◽  
Control Study

Abstract Background For pregnant women with suspected preeclampsia, the soluble fms-like tyrosine-kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio is a biomarker to aid diagnosis. We performed method comparisons between Elecsys® and Kryptor sFlt-1 and PlGF immunoassays and assessed the diagnostic performance for preeclampsia. Methods Serum samples from a case-control study involving 113 pregnant women with preeclampsia/elevated liver enzymes and low platelet count (HELLP) and 270 controls were analyzed. sFlt-1 and PlGF were measured using Roche Elecsys® and BRAHMS Kryptor sFlt-1/PlGF immunoassays. The sFlt-1/PlGF ratios were calculated, and Passing-Bablok regression/Bland-Altman plots were performed. Gestation-specific cut-offs, ≤33 and ≥85/≥110, were assessed. Results Mean (±2 standard deviation [SD]) differences between the Elecsys® and Kryptor values were: sFlt-1, 173.13 pg/mL (6237.66, −5891.40); PlGF, −102.71 pg/mL (186.06, −391.48); and sFlt-1/PlGF, 151.74 (1085.11, −781.63). The Elecsys® and Kryptor immunoassays showed high correlation: Pearson’s correlation coefficients were 0.913 (sFlt-1) and 0.945 (PlGF). Slopes were 1.06 (sFlt-1) and 0.79 (PlGF), resulting in ~20% lower values for Kryptor PlGF. Sensitivities and specificities using the sFlt-1/PlGF ≥85 cut-off for early-onset preeclampsia (20 + 0 to 33 + 6 weeks) were 88.1%/100.0% (Elecsys®) and 90.5%/96.2% (Kryptor), respectively, and using the ≥110 cut-off for late-onset preeclampsia (≥34 + 0 weeks) were 51.3%/96.5% (Elecsys®) and 78.9%/90.1% (Kryptor), respectively. Using Elecsys® and Kryptor sFlt-1/PlGF, 0% and 3.8% of women, respectively, were falsely ruled-in for early-onset, and 3.5% and 9.9%, respectively, for late-onset preeclampsia. Conclusions Despite high correlation between the Elecsys® and Kryptor immunoassays, we observed significant differences between sFlt-1/PlGF and PlGF results. Therefore, sFlt-1/PlGF cut-offs validated for Elecsys® immunoassays are not transferable to Kryptor immunoassays.

scholarly journals Fetomaternal outcome in women with hemolysis, elevated liver enzymes and low platelet count syndrome: a retrospective study

2020 ◽  
Vol 9 (9) ◽  
pp. 3798
Author(s):  
M. B. Divya ◽  
Nishi Roshini Kondakasseril ◽  
Mekkattukunnel Andrews Andrews
Keyword(s):  
Platelet Count ◽  
Retrospective Study ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Fetal Mortality ◽  
Variant Form ◽  
Maternal Complications ◽  
Mortality And Morbidity ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Background: HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome which is a variant form of severe preeclampsia is an important cause of maternal and fetal mortality and morbidity. The importance lies in the early diagnosis and timely intervention for better fetal and maternal outcome. The objective of this study was to assess the maternal and fetal outcome in pregnancies complicated with HELLP syndrome.Methods: This is a retrospective study analyzing fetomaternal outcome in 63 women diagnosed with HELLP syndrome in the department of obstetrics and gynecology, Government Medical College, Thrissur from 1st January 2014 to 31st December 2016. Details were collected from data records library.Results: Among 7,566 deliveries, 63 women (0.83%) had HELLP syndrome. Mean age was 29.5 years. 47.6% (n=30) women developed HELLP syndrome at gestational age less than 34 weeks. Maternal complications were abruption (27.78%), acute kidney injury (16.67%), DIC (16.67%), sepsis (11.11%) and postpartum hemorrhage (11.11%). In this study, HELLP syndrome lead to one maternal death (1.58%). The perinatal mortality was 25.75%.Conclusions: HELLP syndrome is an alarming complication, which brings high maternal and perinatal morbidity and mortality.

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