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syndrome the hellp

Orkun Cetin, Erbil Karaman, Harun Arslan, Ali Kolusarı, Recep Yıldızhan, Mesut Ozgokce, Abdussamet Batur, Ibrahim Akbudak
PURPOSE: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease. MATERIALS AND METHODS: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
Gentle Sunder Shrestha, Shayuja Rajbhandari, Shashwat Dhungel, Nutan Sharma, Nimesh Poudel, Dhiraj N Manandhar
Retinal detachment is a rare, but well-known cause of visual impairment in patients with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. With supportive care, patients usually improve, with complete recovery of vision. Bedside ultrasonography of the orbit can be helpful for early detection of retinal detachment in these patients. Here, we present a case of HELLP syndrome presenting with severe visual symptoms. Retinal detachment was detected with point-of-care ocular sonography, which was confirmed with ophthalmoscopic examination...
September 2016: Indian Journal of Critical Care Medicine
D Mannaerts, E Faes, J Gielis, J Briedé, P Cos, E Van Craenenbroeck, W Gyselaers, J Cornette, M Spaanderman, Y Jacquemyn
AIMS: Oxidative stress is crucial in the pathophysiology of preeclampsia. Reactive oxygen species (ROS) like the superoxide radical O2-, are produced by the ischemic placenta, causing systemic inflammation and endothelial dysfunction. EPR uses microwave radiation and a high magnetic field and is the most direct and reliable method to detect free radicals. We explored the feasibility of determining O2- concentration in maternal serum and compared pre-eclamptic and uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Ji-Hye Kim, Cheonga Yee, Jin-Yi Kuk, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jong-Hwa Kim
Pregnant women with antiphospholipid syndrome (APS) carry a high risk of arterial or venous thrombosis. Such thrombotic conditions occur more frequently in patients with triple positivity to antiphospholipid antibodies or with high antibody titers. Hepatic infarction is a rare complication in pregnant women with APS, and it sometimes mimics HELLP syndrome. This report describes a preeclamptic pregnant woman with APS who had high titers of three antiphospholipid antibodies. She experienced severe epigastric pain with elevated liver enzymes; in addition, she had tachycardia and tachypnea...
September 2016: Obstetrics & Gynecology Science
Adam Morton
A case of undiagnosed pulmonary hypertension in a woman with mixed connective tissue disease presenting with microangiopathic haemolysis, thrombocytopenia and elevated liver enzymes imitating severe preeclampsia (HELLP syndrome) is described. Connective tissue disorders are associated with an increased prevalence of pulmonary hypertension. Maternal mortality rates with pulmonary hypertension in pregnancy are extremely high. All women with connective tissue disorders should have pulmonary hypertension excluded by echocardiography before attempting conception...
December 2013: Obstetric Medicine
Fazoil I Ataullakhanov, Ekaterina M Koltsova, Anna N Balandina, Ilya I Serebriyskiy, Tatiana A Vuimo, Mikhail A Panteleev
Pregnancy is associated with a significant procoagulant shift in the hemostatic system balance as well as other metabolic changes. Pregnancy can thereby provoke manifestation of otherwise dormant disorders of hemostasis (e.g., thrombophilia), or even cause new, pregnancy-specific disorders (e.g., HELLP syndrome). Application and interpretation of laboratory assays of hemostasis in pregnancy is particularly challenging, because normal physiological ranges are no longer applicable, and because the most dangerous and complex changes are not detected by classic routine coagulation/platelet assays...
September 21, 2016: Seminars in Thrombosis and Hemostasis
Betül Başaran, Bilge Çelebioğlu, Ahmet Başaran, Seher Altınel, Leyla Kutlucan, James N Martin
OBJECTIVE: Substantial controversy exists regarding anesthetic management for patients with preeclampsia or hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. Experts, researchers, clinicians, and residents in Turkey were surveyed about their practices. MATERIAL AND METHODS: Questionnaires were distributed to attendees at a national conference, and they were filled out immediately. Anonymous 10-item paper surveys were administered to both residents and non-residents...
2016: Journal of the Turkish German Gynecological Association
Mareike Sandvoß, Arne Björn Potthast, Frauke von Versen-Höynck, Anibh Martin Das
The hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is frequently observed in mothers whose offspring have long-chain fatty acid oxidation defects. We previously found that fatty acid oxidation is compromised not only in these inborn errors of metabolism but also in human umbilical vein endothelial cells (HUVECs) from all pregnancies complicated by the HELLP syndrome. Sirtuins are oxidized nicotinamide adenine dinucleotide (NAD(+))dependent deacetylases linked to the metabolic status of the cell...
September 20, 2016: Reproductive Sciences
Ender Gedik, Neslihan Yücel, Taylan Sahin, Erdinc Koca, Yusuf Ziya Colak, Turkan Togal
PURPOSE: The aim was to assess outcomes for pregnancies in which hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome develops and the patient requires transfer for critical care. MATERIALS AND METHODS: The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. Results were compared for the surviving and non-surviving patients...
September 6, 2016: Hypertension in Pregnancy
Dániel Bereczki, Norbert Szegedi, Zoltán Szakács, István Gubucz, Zsolt May
An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy...
2016: Neurologia i Neurochirurgia Polska
N Hossain, T Shamsi, E Kuczynski, C J Lockwood, M J Paidas
The objective of this study was to evaluate the maternal and perinatal outcome of women with liver dysfunction during pregnancy. The study involved a prospective observational study design and was carried out at the Dow University of Health Sciences and Civil Hospital Karachi, Pakistan. A total of 800 women, who delivered during the study period from January 2006 to September 2006, constituted the study population. Pregnant women with liver dysfunction underwent evaluation for the aetiology of their liver dysfunction, including screening for hepatitis E...
March 2009: Obstetric Medicine
Edikan Archibong, Karthik Raj Konnaiyan, Howard Kaplan, Anna Pyayt
Preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome are pregnancy-related complications with high rates of morbidity and mortality. HELLP syndrome, in particular, can be difficult to diagnose. Recent work suggests that elevated levels of free cell hemoglobin in blood plasma can, as early as the first trimester, potentially serve as a diagnostic biomarker for impending complications. We therefore developed a point-of-care mobile phone-based platform that can quickly characterize a patient's level of hemolysis by measuring the color of blood plasma...
August 16, 2016: Biosensors & Bioelectronics
Cees Bm Oudejans, Ankie Poutsma, Omar J Michel, Hari K Thulluru, Joyce Mulders, Henri J van de Vrugt, Erik A Sistermans, Marie van Dijk
The familial forms of early onset pre-eclampsia and related syndromes (HELLP) present with hypertension and proteinuria in the mother and growth restriction of the fetus. Genetically, these clinically similar entities are caused by different founder-dependent, placentally-expressed paralogous genes. All susceptibility genes (STOX1, lincHELLP, INO80B) identified so far are master control genes that regulate an essential trophoblast differentiation pathway, but act at different entry points. Many genes remain to be identified...
2016: Scientific Reports
M Gabor, M Drab, K Holoman
OBJECTIVES: To perform a complex review of HELLP syndrome and its treatment from up to date scientific literature. Study of the interresting treatement regime of the patient. METHODS: Complex analysis of the syndrome, systematic search of medical scientific databases and Slovak Medical Library. Analysis of the life threatening state of the patient, retrospective analysis of the diagnostics, treatment, acute management, complications and clinical results. RESULTS: According to up to date literature and our good clinical experiences we can encourage the use of high-dose corticosteroid therapy in HELLP syndrome...
2016: Bratislavské Lekárske Listy
Devika Rao, Nikulkumar Kumar Chaudhari, Robert Michael Moore, Belinda Jim
The HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome is believed to be part of the spectrum of pre-eclampsia, which falls within the category of hypertensive disorders of pregnancy. Maternal and fetal complications are more severe in HELLP as opposed to pre-eclampsia alone. We describe a 26-year-old primigravida woman with no medical history who presents with signs of HELLP with marked transaminitis and mild disseminated intravascular coagulation at 35 weeks of gestation who required emergent delivery of the fetus; the patient also sustained acute kidney injury requiring continuous veno-venous hemodiafiltration and a prolonged intensive care unit admission...
2016: BMJ Case Reports
R Khan, K Maduray, J Moodley, T Naicker
OBJECTIVE: The delicate balance which exists between complement activation and its regulation is altered in HIV infection and pregnancy disorders such as pre-eclampsia. Therefore, the purpose of this study was to investigate the expression of complement regulatory (Creg) proteins (CD35 and CD55) in HIV associated normal and pre-eclamptic pregnancies. STUDY DESIGN: The total study population (n=100) consisted of normotensive pregnant (n=50) and pre-eclamptic (n=50) women...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Pl Bozhinov, S Bojinova
PURPOSE: To determine the frequency and the course of hypertensive disorders in pregnant women with epilepsy (PWWE). MATERIALS AND METHODS: The survey is prospective and covers 206 PWWE during the period 1997-2012 year, monitored and treated in Risk Pregnancy Clinic of University Hospital - Pleven. All the patients (PWWE) are with clinically established etiology and prescription of epilepsy, type of seizures and their frequency. EEG records, ultrasound of fetus and cardiotocograph monitoring were conducted...
2016: Akusherstvo i Ginekologii︠a︡
Annettee Nakimuli, Sarah Nakubulwa, Othman Kakaire, Michael Odongo Osinde, Scovia Nalugo Mbalinda, Nelson Kakande, Rose Chalo Nabirye, Dan Kabonge Kaye
BACKGROUND: Hypertensive disorders of pregnancy are a major cause of morbidity and mortality. The objective was to estimate the disease burden attributable to hypertensive disorders of pregnancy in two referral hospitals in Uganda. METHODS: Through a prospective cohort study conducted in Jinja and Mulago hospitals in Uganda from March 1, 2013 and February 28, 2014, hypertension-related cases were analyzed. Maternal near miss cases were defined according to the WHO criteria...
2016: BMC Pregnancy and Childbirth
Guillaume Vogin, François Golfier, Touria Hajri, Agnès Leroux, Béatrice Weber
BACKGROUND: HELLP syndrome is a combination of symptoms described as hemolysis, elevated liver enzymes and low platelets, that complicates 0.01-0.6 % of pregnancies. HELLP syndrome has been scarcely reported associated with partial moles, another rare complication of pregnancy. This manuscript describes the only reported case of HELLP syndrome associated with a complete invasive hydatiform mole. CASE PRESENTATION: We report a perimenopausal patient in prolonged remission from an uncommon high-risk invasive complete mole...
2016: BMC Cancer
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