Poster Presentation Australian Institute of Medical Scientists National Scientific Meeting 2013

HELLP Syndrome: a laboratory perspective (#107)

Ana Maluenda 1 , Helen Bardsley
  1. RMIT University, Bundoora, VIC, Australia
HELLP is characterised by haemolysis, elevated liver enzymes and low platelets. Patients may have complete or partial HELLP. The aim of this study was to evaluate cases received at Austin Health between 2005-2013 to correlate the laboratory findings with the literature criteria. A total of 496 cases were analysed, among which 78 HELLP patients were identified. The age of patients with HELLP ranged from 24-44 years old and the gestation age ranged from 23-40 weeks. The laboratory findings on the first day of presentation included platelet count, bilirubin, ALT, LD and the presence of schistocytes. The percentage of patients with each of the laboratory parameters as well as the percentage of patients with 2 or 3 features of the HELLP criteria was calculated. 21% of cases revealed PLT count ≤50x10^9/L (class 1 of Mississipi classification) and 79% with PLT >50 - ≤100x10^9/L (class 2). 15% of class 1 patients and 24% of class 2 had bilirubin ≥20.5 micromol/L. 19% of class 1 and 63% of class 2 had ALT ≥70 IU/L. 20% of class 1 and 33% of class 2 had LD ≥2x and all cases of class 1 and 40% of class 2 had schistocytes. Based on the results, 47% of patients revealed partial HELLP and 53% were considered with complete HELLP. The exclusion of a number of cases during the analysis reveals the difficulty of performing comparison studies because HELLP diagnosis has often been based on different criteria. In addition, there is no standard test profile for HELLP patients. Further statistical analysis and integration of results at different times of presentation would be beneficial to support further conclusions.