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首页> 外文期刊>Open Journal of Obstetrics and Gynecology >Pregnant-Postpartum Women with Severe Epigastric Pain and HELLP Syndrome: A Highly Dangerous Combination
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Pregnant-Postpartum Women with Severe Epigastric Pain and HELLP Syndrome: A Highly Dangerous Combination

机译：怀孕后妇女严重的颠膜疼痛和地狱综合征：一种高度危险的组合

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OBJECTIVE: HELLP syndrome is a severe preeclampsia spectrum disorder diagnosed when laboratory evidence of hemolysis, liver dysfunction and thrombocytopenia are present. The presence of epigastric pain with laboratory criteria for HELLP syndrome may indicate higher maternal-fetal risk. Thus we explored maternal outcomes in 42 pregnant/postpartum women that had HELLP syndrome by laboratory criteria in addition to sudden severe epigastric pain. METHODS: A database was constructed from the medical files of all patients with medical/hypertensive disorders evaluated by the first author from 1986-2015 for medicolegal purposes. All patient files of women who presented to their physicians with a diagnosis of presumptive HELLP syndrome were examined. RESULTS: Fifty - eight pregnant/postpartum women fulfilled study inclusion criteria; they presented to physicians for evaluation usually in non-tertiary care hospital settings. Clinical presentation and care including lab data and details of pregnancy outcome were evaluated. A correct diagnosis of HELLP syndrome was verified for 42 women (72.4%); others were determined to have AFLP-Acute Fatty Liver of Pregnancy (n = 8) or TTP-aHUS-Thrombotic thrombocytopenic purpura-adult/atypical hemolytic uremic syndrome (n = 8). All 42 HELLP women (100%) in our cohort had severe epigastric pain. Treatment modalities for maternal HELLP syndrome included magnesium sulfate (n = 35, 83%), antihypertensives (n = 17, 40%); corticosteroids (CORT) for HELLP were not utilized. Major maternal morbidity (21 strokes, 9 liver ruptures/hematomas) affected 41 HELLP women (98%); 22 died, 7 were permanently disabled. CONCLUSION: HELLP syndrome patients presenting with sudden, severe epigastric pain in this highly select ed cohort experienced very high maternal morbidity and mortality. Laboratory evidence of HELLP syndrome in association with epigastric pain is a dangerous combination that portends great danger to safe motherhood. We speculate that the absence of CORT use in this cohort contributed to poor maternal outcome (word count = 280 as modified for reviewers) .
机译：目的：HellP综合征是一种严重的先兆子痫谱系诊断，当时溶血的证据，存在肝功能障碍和血小板减少症。 HellP综合征的实验室标准的颠膜疼痛的存在可能表明母亲胎儿风险较高。因此，除了突然严重的颠膜疼痛之外，我们还探讨了42名怀孕/产后女性的孕产妇结果，除了突然的颠膜痛。 方法：由第一个作者从1986 - 2015年评估的医疗/高血压障碍患者的医疗文件构建了数据库，从1986 - 2015年从1986 - 2015年评估为Medicolegal目的。审查了所有患者的患者的患者患有诊断提出了推定Hellp综合征的医生。 结果：五十八名孕妇/产后妇女满足研究纳入标准;它们通常在非高等教育医院环境中呈现给医生进行评估。评估了临床介绍和护理，包括实验室数据和妊娠结局的细节。 42名女性（72.4％）核实了HellP综合征的正确诊断;其他人被确定为妊娠的AFLP-急性脂肪肝（n = 8）或TTP-AHUS血栓形成血小板减少紫癜 - 成人/非典型溶血性呼吸症（n = 8）。我们的队列中的所有42名Hellp女性（100％）患有严重的昙花一现。母体HellP综合征的治疗方式包括硫酸镁（n = 35,83％），抗高血压（n = 17,40％）;没有使用Hellp的皮质类固醇（CORT）。主要孕产妇发病率（21例，9肝硬化/血肿）影响了41名Hellp女性（98％）; 22死亡，7个被永久禁用。 结论：HellP综合征患者突然呈现出突然的，严重的心肌疼痛在这种高度选择的Ed Combort经历了非常高的母体发病率和死亡率。 HellP综合征与ePigastric疼痛结合的实验室证据是一种危险的组合，对安全的母性进行了巨大危险。我们推测，这种队列中没有Cort使用造成的孕产妇结果差（Word Count = 280，用于审阅者的修改）。

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