HELLP syndrome is a life-threatening pregnancy complication. It usually occurs during the later stages of pregnancy, or sometimes after childbirth.
At Austin Health we have been performing the Pathology testing for Mercy Hospital for Women since May 2005. Since that time we have seen a number of patients present to the hospital with clinical symptoms and laboratory findings suggestive of HELLP syndrome.
In March this year I performed data extractions dating back to 2005 to assess if our laboratory findings correlate with current literature information. The data extracted included patient age, gestation, platelet count < 100 x10^9/l, total bilirubin, ALT, AST, LDH, Uric acid, DDimer, blood film reports and clinical history.
Transfusion history ofl patients identified with HELLP was also reviewed. In HELLP thrombocytopenia is due to increased consumption and /or destruction of platelets. Therefore prior to surgery or vaginal delivery patients may require platelet transfusion. If there are complications, for example placental abruption, transfusion with red cells, fresh frozen plasma may also be required. The transfusion history was reviewed to assess how many patients received blood products and the type and quantities required to meet the clinical patient needs.
There were 78 cases of HELLP identified from the data. Of those ,21(27%) patients required transfusion with one or more blood products. !8 patients received platelet transfusion and 9 (50%) received more than 1 pooled bag of platelets.Our transfusion statistics appear to correlate with recently reviewed data.