ADOLESCENT PREGNANCIES COMPLICATED BY HELLP SYNDROME: CLINICAL EXPERIENCE OF 26 CASES

Yıl 2013, Cilt: 10 Sayı: 40, 1643 - 1646, 01.10.2013

Selçuk Erkılınç Elif Gül Yapar Eyi

Öz

Aim: We aimed to evaluate clinical characteristics of adolescent pregnancies complicated by HELLP syndrome. Materials and Method: Clinical and laboratory findings of 26 patients with complete HELLP syndrome between age 17 and 20 were collected from hospital records. Data included age, gravida, parity, chronic hypertension, gestational age at diagnosis, mean arterial blood pressure, and adverse maternal outcomes as eclampsia, disseminated intravascular coagulopathy DIC , acute renal failure, pulmonary edema, abruptio placentae, pleural effusion, ascites, transfusion and death. Results: Mean age and standart deviation of the patients with HELLP Syndrome at diagnosis was 18,5 ±0,9. Gestational age at diagnosis was subdivided into three groups as smaller than or equal to 28, between 281/7 and 320 /7, and 321/7 to 370 /7 weeks and greater than 37 weeks of gestation with corresponding rates of 3,8%, 19,1%, and 54,1%, 23.0%, respectively. There was at least one maternal complication in 46,2% of the patients. No maternal death occurred during study period. The most common adverse maternal outcome was transfusion of blood products with a ratio of 26,9%. Adverse maternal outcomes were as follows; DIC: 7,7% 2 patients , abruptio placenta: 3,8% 1 patient , acute renal failure: 3,8% 1 patient , incisional hematoma: 11.5% 3 patients , ascites: 3,8% 1 patient , intrauterine/neonatal death 3,8%. 1 patient . Preterm delivery and eclampsia with HELLP syndrome occurred in 77% 20 patients , and 23,1% 6 patients , of the patients, respectively. Statistical analysis was carried out with SPSS 15 programme. Conclusion: Preterm delivery and eclampsia had a higher incidence among the adolescents complicated by HELLP syndrome compared to the patients with HELLP syndrome of all ages.

Anahtar Kelimeler

adolescent pregnancies, HELLP syndrome, clinical experience

ADOLESAN GEBELİKLERDE HELLP SENDROMU: 26 OLGULUK KLİNİK DENEYİM

Öz

Amaç: HELLP sendromu ile komplike adolesan gebeliklerin klinik özelliklerinin değerlendirilmesi amaçlanmıştır. Gereçler ve Yöntem: Çalışmaya hastane kayıtlarından elde edilen 17 ve 20 yaş arasında tam HELLP sendromlu 26 hastanın klinik ve laboratuvar verileri dahil edildi. Değerlendirmede yaş, gravida, parite, kronik hipertansiyon, tanı sırasındaki gebelik yaşı, ortalama arteriyel kan basıncı ve eklampsi gibi olumsuz maternal sonuçlar,yaygın damar içi pıhtılaşma DIC , akut böbrek yetmezliği, pulmoner ödem , plasenta dekolmanı, plevral efüzyon, asit, transfüzyonu ve anne ölümü kriter alındı. Veriler SPSS 15 programında değerlendirildi. Bulgular: Adolesan HELLP sendromlu olgularda ortalama yaş ve standart sapma 18,5 ± 0,9 idi. Tanı sırasındaki gebelik haftaları sırasıyla 28 hafta ve altı: %3,8; 281/7 - 320 /7 arası: %19,1; 321/7 - 370/7 arası: %54,1; 37 hafta, ve üzeri: %23 olmak üzere dört gruba ayrıldı. Hastaların %46,2'en az bir maternal komplikasyon vardı. Anne ölümü görülmedi. Çalışma döneminde oluştu. En çok görülen advers maternal sonuç %26,9 oranı ile kan ürünleri transfüzyonu olarak belirlenirken, advers maternal sonuçlar; DIC: 7,7 % hasta , plasenta dekolmanı: % 3,8 1 hasta , akut böbrek yetmezliği: %3,8 1 hasta , insizyonel hematom: % 11.5 3 hasta , asit: %3,8 1 hasta , intrauterin / neonatal ölüm %3,8 1 hasta oranında görüldü. HELLP sendromlu hastalarda erken doğum, %77 20 hasta ve ve eklampsi %23,1 6 hasta oranında ortaya çıktı. Sonuç: Erken doğum ve eklampsi, adolesanlarda her yaştan HELLP sendromlu hastalara göre daha yüksek orandadır.

Anahtar Kelimeler

adölesan gebelik, HELLP sendromu, klinik deneyim

Kaynakça

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