Neonatal outcome in severe preeclampsia at 24 to 36 weeks' gestation: Doesthe HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome matter?

OBJECTIVE: Our purpose was to compare neonatal outcome after preterm delive ry of infants whose gestation was complicated by the HELLP (hemolysis, elev ated liver enzymes, and low platelet count) syndrome, partial HELLP syndrom e, or severe preeclampsia. STUDY DESIGN: We reviewed the maternal and neonatal charts from 269 consecu tive pregnancies complicated by the HELLP syndrome or severe preeclampsia m anaged at our perinatal center. The HELLP syndrome was defined by previousl y published laboratory criteria. Viable pregnancies were divided into 3 gro ups: HELLP syndrome, partial HELLP syndrome (at least 1, but not all 3, fea tures of the HELLP syndrome), and severe preeclampsia (no features of the H ELLP syndrome). Results were compared by means of chi(2) analysis and Stude nt t test where appropriate. Logistic regression was used to evaluate outco me variables at different gestational ages. RESULTS: There were no significant differences in complications among the 3 groups at each gestational age. There was, as expected, a significant decr ease in morbidity and mortality rates with advanced gestational age. CONCLUSIONS: In severe preeclampsia, neonatal morbidity and death are relat ed to gestational age rather than to the presence or absence of the HELLP s yndrome. Whether expectant management is safe for women with the HELLP synd rome requires further study.