Alteration of homocysteine catabolism in pre-eclampsia, HELLP syndrome and placental insufficiency

2004 ◽  
Vol 42 (10) ◽  
Author(s):  
Wolfgang Herrmann ◽  
Ulrich Hübner ◽  
Ines Koch ◽  
Rima Obeid ◽  
Ulrich Retzke ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Methylmalonic Acid ◽  
Placental Insufficiency ◽  
B Vitamins ◽  
Fasting Serum ◽  
Obstetrical Complications ◽  
Elevated Liver Enzymes

AbstractHyperhomocysteinemia is a risk factor in obstetrical complications such as pre-eclampsia, ‘hemolysis, elevated liver enzymes, low platelet’ (HELLP)-syndrome and placental insufficiency. The aim of our study was to investigate the alterations of homocysteine catabolism in these patients in relation to serum B-vitamins and renal function. Maternal fasting serum from preeclampsia (n = 24), HELLP (n = 20) and placental insufficiency (n = 25) patients at the time of diagnosis and pregnant controls (n = 34) was analyzed for homocysteine and its metabolites cystathionine and methylmalonic acid, the vitamins B

scholarly journals Normotensive HELLP syndrome in the midst of Dengue fever

2018 ◽  
Vol 9 (2) ◽  
pp. 40-42
Author(s):  
Robin George Manappallil ◽  
Sithara Surendran ◽  
Anoop Kumar ◽  
Ganga Prasad
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Dengue Fever ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Elevated Blood ◽  
Medical Sciences ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
Life Threatening Complication

HELLP syndrome is a life threatening complication of pregnancy, characterized by haemolysis, elevated liver enzymes and low platelet counts. Preeclampsia is a risk factor for developing HELLP. However, some patients can have HELLP in the absence of elevated blood pressure. Dengue fever is a mosquito-borne viral infection characterized by fever, leucopenia and thrombocytopenia, and bleeding manifestations. This is a case of a young primigravida who presented with dengue fever and was found to have an associated normotensive HELLP syndrome.Asian Journal of Medical Sciences Vol.9(2) 2018 40-42

scholarly journals Haemolysis, elevated liver enzymes and low platelets: Diagnosis and management in critical care

2021 ◽  
pp. 175114372110254
Author(s):  
Evangelia Poimenidi ◽  
Yavor Metodiev ◽  
Natasha Nicole Archer ◽  
Richard Jackson ◽  
Mansoor Nawaz Bangash ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critical Care ◽  
Liver Failure ◽  
Hellp Syndrome ◽  
Seizure Control ◽  
Liver Enzymes ◽  
Kidney Injury ◽  
Definitive Treatment ◽  
Multisystem Disease ◽  
Elevated Liver Enzymes

A thirty-year-old pregnant woman was admitted to hospital with headache and gastrointestinal discomfort. She developed peripheral oedema and had an emergency caesarean section following an episode of tonic-clonic seizures. Her delivery was further complicated by postpartum haemorrhage and she was admitted to the Intensive Care Unit (ICU) for further resuscitation and seizure control which required infusions of magnesium and multiple anticonvulsants. Despite haemodynamic optimisation she developed an acute kidney injury with evidence of liver damage, thrombocytopenia and haemolysis. Haemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome, a multisystem disease of advanced pregnancy which overlaps with pre-eclampsia, was diagnosed. HELLP syndrome is associated with a range of complications which may require critical care support, including placental abruption and foetal loss, acute kidney injury, microangiopathic haemolytic anaemia, acute liver failure and liver capsule rupture. Definitive treatment of HELLP is delivery of the fetus and in its most severe forms requires admission to the ICU for multiorgan support. Therapeutic strategies in ICU are mainly supportive and include blood pressure control, meticulous fluid balance and possibly escalation to renal replacement therapy, mechanical ventilation, neuroprotection, seizure control, and management of liver failure-related complications. Multidisciplinary input is essential for optimal treatment.

scholarly journals Hemolysis, Elevated Liver Enzymes and Low Platelet (HELLP) Syndrome Associated with Systemic Lupus Erythematosus

2003 ◽  
Vol 42 (10) ◽  
pp. 1052-1053 ◽  
Author(s):  
Masayuki MATSUDA ◽  
Shigeaki MITSUHASHI ◽  
Megumi WATARAI ◽  
Kanji YAMAMOTO ◽  
Takao HASHIMOTO ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Systemic Lupus ◽  
Elevated Liver Enzymes

scholarly journals The psychological experience of women who survived HELLP syndrome in Cape Town, South Africa

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Rizwana Roomaney ◽  
Michelle G. Andipatin ◽  
Anika Naidoo
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Blood Platelets ◽  
African Women ◽  
Theory Approach ◽  
Psychological Experience ◽  
Lack Of Information ◽  
Risk Pregnancy ◽  
Elevated Liver Enzymes ◽  
South African Women

Background: Haemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) is a high-risk pregnancy condition that could be fatal to mother and/or baby. It is characterised, as the acronym indicates, by haemolysis, elevated liver enzymes and low blood platelets. Objective: This study explored women in Cape Town’s psychological experience of HELLP syndrome.Method: Six participants who previously experienced HELLP syndrome were interviewed. Using a grounded theory approach, themes emerged and a model illlustrating the psychological experience of HELLP syndrome was constructed.Results: The major themes that emerged were the perceived lack of information, a need to assign blame and a shift in focus. Themes of not knowing and trance and/or surreal experience underpin the cognitive aspects of the HELLP syndrome experience. Themes that expressed feelings of an inability to control, whirlwind and/or rapid pace and support acted together to bind the experience. Finally, emotions such as anger, ambivalence, disbelief, anxiety, guilt, loneliness and fear were present throughout the experience.Conclusion: This study developed an initial exploratory model representing the psychological experience of HELLP syndrome in a sample of South African women. Underlying this entire experience was a perceived lack of information which had a profound effect on numerous aspects of the experience ranging from where to locate blame to the varied emotions experienced. Agtergrond: Die HELLP sindroom is ‘n hoë-risiko swangerskap toestand wat kan dodelik vir moeder en/of baba wees. Dit word gekenmerk deur hemolise, verhoogde lewerensieme en lae bloedplaatjies.Doelwit: Hierdie studie het Suid-Afrikaanse vroue se sielkundige ervaring van die HELLP sindroom ondersoek.Metode: Ses deelnemers wat voorheen HELLP sindroom ervaar het is ondervra. Met die gebuik van gefundeerde teorie as ‘n teoretiese raamwerk en ontleding het temas na vore gekom en ‘n model wat die sielkundige ervaring van HELLP sindroom illustreer, is gebou.Resultate: Die vernaamste temas wat na vore gekom het was die oënskynlike gebrek aan inligting, ‘n behoefte om skuld toe te skryf en ‘n verskuiwing in fokus. Die tema van nie weet en beswyming en/of surrealistiese ervaring ondersteun die kognitiewe aspekte van die HELLP sindroom. Temas wat gevoelens van geen beheer, warrelwind en/of vinnige tempo en ondersteuning uitgesprek het, het saam opgetree om die ervaring te bind. Ten slotte, emosies soos woede, teenstrydigheid, ongeloof, angs, skuldgevoelens, eensaamheid en vrees was teenwoordig in die hele ervaring.Gevolgtrekking: Hierdie studie het van’n aanvanklike ondersoekende model van die sielkundige ervaring van HELLP sindroom tot ‘n steekproef van die Suid-Afrikaanse vroue ontwikkel. Onderliggend aan hierdie hele ervaring was ‘n oënskynlike gebrek aan inligting wat ‘n diepgaande uitwerking gehad het op talle aspekte van die ervaring wat gewissel het van waar om die blaam te plaas tot die uiteenlopende ervaarde emosies.

scholarly journals Comparison of Maternal and Neonatal Outcomes between Acute Fatty Liver of Pregnancy and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen
Keyword(s):  
Cohort Study ◽  
Fatty Liver ◽  
Retrospective Cohort Study ◽  
Hellp Syndrome ◽  
Retrospective Cohort ◽  
Liver Enzymes ◽  
Neonatal Outcomes ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver ◽  
Maternal And Neonatal Outcomes

Abstract Background: Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome.Methods: This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were analyzed.Results: During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0% versus 23.8%) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7% versus 13.8%), acute kidney injury (61.9% versus 15.0%), disseminated intravascular coagulopathy (66.7% versus 8.8%), and sepsis (47.6% versus 10.0%) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1% versus 33.3%), neonatal respiratory distress syndrome (39.2% versus 8.3%) and neonatal sepsis (34.2% versus 12.5%) were noted in the HELLP syndrome group.Conclusions: AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.

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 Ruptured subcapsular hepatic hematoma complicating severe preeclampsia with haemolysis, elevated liver enzymes, low platelet count syndrome: a case report

2020 ◽  
Vol 9 (11) ◽  
pp. 4726
Author(s):  
Ashok R. Anand ◽  
Binita H. Shah ◽  
Pratibha Vashisth
Keyword(s):  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Treatment Options ◽  
Severe Preeclampsia ◽  
Medical Support ◽  
Artery Ligation ◽  
Hepatic Hematoma ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Subcapsular liver hematoma is rare complication of severe preeclampsia and HELLP syndrome, thus making it essential for these patients to be followed up in critical and intensive care units for advanced medical support with fluid and electrolyte management and replacement of blood products while treating underlying disorders. Treatment options have to be individualised and vary from conservative management to surgical treatment including hepatic resection, hepatic artery ligation, and liver transplantation. In this paper we report a case of ruptured hepatic hematoma in a 35 year old female, few hours within delivery, a complication of severe preeclampsia and HELLP syndrome

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