ABSTRACT
Pregnancies complicated by the syndrome of hemolysis, elevated liver enzymes, and
low platelet count (HELLP) have been associated with both a poor maternal and a poor
neonatal outcome in several publications. Because many studies were small and gave
only scant information regarding the infants, we analyzed the clinical course of 89
neonates born to mothers with the HELLP syndrome. Ninety-eight percent of the neo-nates
were born by cesarean section. Infants with a maternal HELLP syndrome were often small
for gestational age (39%). The incidence of perinatal asphyxia was found to be 5.6%.
Additionally, the affected very low birthweight (VLBW) infants had relatively high
incidences of leukopenia (21%), neutropenia (33%), and thrombocytopenia (33%). Initially,
54% of the LBW infants were found to have normoblasts and 25% erythrocytosis. The
incidence of these changes in blood cell count increased with decreasing birth-weight.
Nosocomial infections occurred more often in infants with a reduced neutrophil count.
The overall mortality rate was 56 per 1000. Comparing the statistics of the VLBW infants
with a maternal HELLP syndrome (n = 32) to all infants with a birthweight less than
1500g (n = 521) during the investigational period, we found a similar mortality rate
(9.3% and 8.4%, respectively). The pulmonary morbidity was also similar. The incidence
of intracranial hemorrhage in VLBW infants with a maternal HELLP syndrome was lower
(12.5% versus 18.2%) and of necrotizing enterocolitis was higher (6.2% versus 1.9%).
Keywords
HELLP syndrome - neonatal outcome - blood cell count
