[Frequency and maternal complications of the criteria of hemolysis in preeclamptic patients with HELLP syndrome treated in an intensive care unit].

BACKGROUND: HELLP syndrome is an aggressive form of preeclampsia related with hemolysis and its complications.

OBJECTIVE: To determine the frequency of the appearance of criteria of hemolysis and maternal complications in preeclamptic patients with HELLP syndrome treated in an intensive care unit.

MATERIAL AND METHODS: We carried out a cross-sectional study in 50 preeclamptic women with HELLP syndrome admitted to intensive care unit to determine the presence of the following criteria of hemolysis: peripheral blood schistocytes, anemia (hemoglobin ≤ 10 g/dL), lactate dehydrogenase ≥ 600 U/L, indirect bilirubin ≥ 0.6 mg/dL and hemoglobinuria. We also studied maternal complications in patients with lactate dehydrogenase ≥ 600 U/L and positive for schistocytes. Descriptive (mean, median, range, standard deviation) and inferential (Student t test) statistics were used.

RESULTS: Lactate dehydrogenase ≥ 600 U/L was found in 36%, indirect bilirubin 0.6 mg/dL in 20%, positive schistocytes in 16%, hemoglobinuria in 4% and anemia in 0%. Patients with lactate dehydrogenase ≥ 600 U/L had more clinical and laboratory deterioration as well as prolonged intensive care unit stay (p = 0.0025). Patients positive for schistocytes did not demonstrate adverse effects.

CONCLUSION: Biochemical criteria of hemolysis were more frequent than schistocytes, hemoglobinuria and anemia. Patients with lactate dehydrogenase ≥ 600 U/L was alterations more serious than patients with positive schistocytes so its usefulness as a biomarker may be higher.