INCREASED SERUM LEVELS OF HYALURONIC-ACID IN PREGNANCIES COMPLICATED BY PREECLAMPSIA OR HEMOLYSIS, ELEVATED LIVER-ENZYMES, AND LOW PLATELETS SYNDROME

OBJECTIVE: Fifteen percent of patients who later have hemolysis, eleva ted liver enzymes, and low platelets syndrome develop initially have n onspecific symptoms. Early diagnosis could ensure adequate obstetric m anagement; however, prognostic biochemical tests are lacking. We hypot hesized that elevated hyaluronic acid serum levels might be an early i ndicator of hemolysis, elevated liver enzymes, and low platelets syndr ome because it is known to be a sensitive marker of liver cell functio n. STUDY DESIGN: Hyaluronic acid in serum was measured in patients wit h normal pregnancies (n = 109) and in those patients with pregnancies complicated by preeclampsia (n = 14) or Hemolysis, elevated liver enzy mes, and low platelets syndrome (n = 11). RESULTS: A significant incre ase in hyaluronic acid serum concentrations was observed in patients w ith hemolysis, elevated liver enzymes, and low platelets syndrome or w ith preeclampsia (p < 0.05). The extent of hyaluronic acid serum level s in hemolysis, elevated liver enzymes, and low platelets syndrome cor related with the clinical severity of the individual course of disease as measured by intensive care unit time (r = 0.72; p<0.02). CONCLUSIO NS: Serum levels of hyaluronic acid in preeclampsia and hemolysis, ele vated liver enzymes, and low platelets syndrome are significantly elev ated and might play an important diagnostic and prognostic role in pat ients with hemolysis, elevated liver enzymes, and low platelets syndro me.