Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes
Abstract Background HELLP syndrome refers to a group of clinical syndromes characterized by hemolysis, elevated liver enzymes and low platelet, and the evidence on the association between proteinuria and the severity of HELLP and its maternal and neonatal outcomes is rare. Methods 106 pregnant women...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-023-05862-5 |
| _version_ | 1797555797491712000 |
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| author | Yan Jiao Yan Liu Hongyuan Li Zimeng Song Shiliang Wang Jiao Zhang Jian Li Jia Liu Peng Wang Yanhong Chen |
| author_facet | Yan Jiao Yan Liu Hongyuan Li Zimeng Song Shiliang Wang Jiao Zhang Jian Li Jia Liu Peng Wang Yanhong Chen |
| author_sort | Yan Jiao |
| collection | DOAJ |
| description | Abstract Background HELLP syndrome refers to a group of clinical syndromes characterized by hemolysis, elevated liver enzymes and low platelet, and the evidence on the association between proteinuria and the severity of HELLP and its maternal and neonatal outcomes is rare. Methods 106 pregnant women were assigned to the proteinuric group (24-hUPro ≥ 0.3 g, 79 cases) and the non-proteinuric group (24-hUPro < 0.3 g, 27 cases). The proteinuric group was further divided into three subgroups: mild group (24-hUPro:0.3-2.0 g, 33 cases), moderate group (24-hUPro:2.0-5.0 g, 21 cases) and severe group (24-hUPro: ≥5.0 g, 25 cases). The general clinical data, laboratory indexes, complications and pregnancy outcome and adverse neonatal outcomes of HELLP with or without proteinuric were analyzed. Results Compared with proteinuric group, the non-albuminuric group or in the three proteinuric subgroups of HELLP pregnant women’s, increased proteinuria was associated with earlier onset gestations, higher incidence of abdominal pain, skin jaundice, headache, blurred vision (p < 0.05 respectively), and also the higher levels of ALT, AST, LDH, Fib, APTT, ATII, proportions of tubular urine and lower levels of ALB, PLT (p < 0.05 respectively). In the three subgroups of the proteinuric group, the ratio of fetal growth restriction, cesarean section and postpartum hemorrhage were compared, and the difference was statistically significant (p < 0.05 respectively). Compared with the proteinuric group, the non-proteinuric group had higher birth weight, birth length, and lower SGA, admission rate in NICU (p < 0.05 respectively). In the three subgroups of the proteinuric group, significant differences were identified in the adverse outcomes of newborns (p < 0.05 respectively), and the incidence of adverse outcomes in neonates tended to be higher. Significant differences were identified in birth weight, birth length, and lower SGA and NICU occupancy rate among the three subgroups (p < 0.05 respectively). Conclusions HELLP syndrome is a severe complication of pregnancy, involving multiple systems of the whole body. It has posed a great challenge to obstetricians for its acute onset, dangerous condition, rapid progress, and great harm. Thus, insights into HELLP syndrome should be gained, and early diagnosis, early treatment and timely termination of pregnancy should be conducted to reduce the incidence of maternal and fetal adverse outcomes and improve maternal and fetal prognosis. |
| first_indexed | 2024-03-10T16:52:47Z |
| format | Article |
| id | doaj.art-3b39ceeb707f4976bd04c7ea86ba5682 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-10T16:52:47Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-3b39ceeb707f4976bd04c7ea86ba56822023-11-20T11:14:01ZengBMCBMC Pregnancy and Childbirth1471-23932023-08-0123111010.1186/s12884-023-05862-5Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomesYan Jiao0Yan Liu1Hongyuan Li2Zimeng Song3Shiliang Wang4Jiao Zhang5Jian Li6Jia Liu7Peng Wang8Yanhong Chen9Department of obstetrics and gynecology of Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalDepartment of neurology, Xuzhou Central HospitalSchool of medical technology, Xuzhou Medical UniversityDepartment of obstetrics and gynecology of Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalDepartment of Clinical Laboratory, Xuzhou Central HospitalAbstract Background HELLP syndrome refers to a group of clinical syndromes characterized by hemolysis, elevated liver enzymes and low platelet, and the evidence on the association between proteinuria and the severity of HELLP and its maternal and neonatal outcomes is rare. Methods 106 pregnant women were assigned to the proteinuric group (24-hUPro ≥ 0.3 g, 79 cases) and the non-proteinuric group (24-hUPro < 0.3 g, 27 cases). The proteinuric group was further divided into three subgroups: mild group (24-hUPro:0.3-2.0 g, 33 cases), moderate group (24-hUPro:2.0-5.0 g, 21 cases) and severe group (24-hUPro: ≥5.0 g, 25 cases). The general clinical data, laboratory indexes, complications and pregnancy outcome and adverse neonatal outcomes of HELLP with or without proteinuric were analyzed. Results Compared with proteinuric group, the non-albuminuric group or in the three proteinuric subgroups of HELLP pregnant women’s, increased proteinuria was associated with earlier onset gestations, higher incidence of abdominal pain, skin jaundice, headache, blurred vision (p < 0.05 respectively), and also the higher levels of ALT, AST, LDH, Fib, APTT, ATII, proportions of tubular urine and lower levels of ALB, PLT (p < 0.05 respectively). In the three subgroups of the proteinuric group, the ratio of fetal growth restriction, cesarean section and postpartum hemorrhage were compared, and the difference was statistically significant (p < 0.05 respectively). Compared with the proteinuric group, the non-proteinuric group had higher birth weight, birth length, and lower SGA, admission rate in NICU (p < 0.05 respectively). In the three subgroups of the proteinuric group, significant differences were identified in the adverse outcomes of newborns (p < 0.05 respectively), and the incidence of adverse outcomes in neonates tended to be higher. Significant differences were identified in birth weight, birth length, and lower SGA and NICU occupancy rate among the three subgroups (p < 0.05 respectively). Conclusions HELLP syndrome is a severe complication of pregnancy, involving multiple systems of the whole body. It has posed a great challenge to obstetricians for its acute onset, dangerous condition, rapid progress, and great harm. Thus, insights into HELLP syndrome should be gained, and early diagnosis, early treatment and timely termination of pregnancy should be conducted to reduce the incidence of maternal and fetal adverse outcomes and improve maternal and fetal prognosis.https://doi.org/10.1186/s12884-023-05862-5ProteinuriaHELLPSeverity of illness indexPregnancy complicationsPregnancy outcome |
| spellingShingle | Yan Jiao Yan Liu Hongyuan Li Zimeng Song Shiliang Wang Jiao Zhang Jian Li Jia Liu Peng Wang Yanhong Chen Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes BMC Pregnancy and Childbirth Proteinuria HELLP Severity of illness index Pregnancy complications Pregnancy outcome |
| title | Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes |
| title_full | Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes |
| title_fullStr | Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes |
| title_full_unstemmed | Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes |
| title_short | Value of proteinuria in evaluating the severity of HELLP and its maternal and neonatal outcomes |
| title_sort | value of proteinuria in evaluating the severity of hellp and its maternal and neonatal outcomes |
| topic | Proteinuria HELLP Severity of illness index Pregnancy complications Pregnancy outcome |
| url | https://doi.org/10.1186/s12884-023-05862-5 |
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