Appraisal of Short- and Long-Term Outcomes of Partial Versus Complete HELLP Syndromes: A Retrospective Cohort Study

Abstract

To compare short-term outcomes at index and subsequent pregnancies, as well as the long-term medical complications encountered later than 5 years after index pregnancy incomplete and partial HELLP syndromes. Pregnancies complicated by partial HELLP or complete HELLP during a period of 19 years were identified. Searches were limited to cases before 2012 to ensure an adequate follow-up period. Data on index or subsequent pregnancies occurring at our center were extracted from the hospital database, while data pertaining to subsequent obstetric outcomes when deliveries occurred elsewhere together with current medical conditions were acquired by patient self-reporting. Complete HELLP was defined as the presence of the 3 components of the syndrome whereas partial HELLP was defined by the presence of 1 or 2 components. 100 pregnancies were included. At index pregnancy, there was a higher rate of composite adverse maternal outcome in complete HELLP when compared to partial HELLP (45.8% vs 21.1%, p = 0.017). Outcomes at subsequent pregnancies showed no difference between the two variants of HELLP syndrome. When examined years later, a higher frequency of “composite medical morbidity” in the complete HELLP group was observed, though this difference did not reach statistical significance (77.7% vs 61.9%, p = 1.00). Although partial HELLP is relatively less harmful, it can nonetheless cause serious maternal complications including ruptured liver hematoma, intracranial hemorrhage and even mortality. These two clinical entities represent a continuum of the same pathology, which implies that the approach at management should be uniform. Furthermore, the prognosis and long-term outcomes were not different between these 2 variants.

Keywords

Complete HELLP - HELLP syndrome - Long-term outcome - Partial HELLP - Short-term outcome

Publication History

Received: 28 July 2021

Accepted: 02 September 2021

Article published online:
05 May 2023