Comparison of Maternal and Perinatal Outcomes between Severe Preeclampsia without Complications and with HELLP Syndrome

Salma Nisrina Riva; Adhi Pribadi; Amillia Siddiq

doi:10.24198/obgynia.v7i2.719

Comparison of Maternal and Perinatal Outcomes between Severe Preeclampsia without Complications and with HELLP Syndrome

Salma Nisrina Riva, Adhi Pribadi, Amillia Siddiq

Abstract

Introduction: Maternal and perinatal outcomes in severe preeclampsia conditions, without or accompanied by HELLP syndrome, are variable. There is currently a lack of research data in Indonesia comparing maternal and perinatal outcomes in both conditions. This study compares pregnancy outcomes between severe preeclampsia with no complications and severe preeclampsia with HELLP syndrome.
Methods: This study employs an observational analytical approach, utilizing a retrospective cross-sectional design. The samplings contain 92 patients from the medical records of patients who were diagnosed with preeclampsia without complications and severe preeclampsia with HELLP syndrome at Hasan Sadikin Hospital Bandung from January 2021 to December 2023.
Results: It was found that maternal with HELLP syndrome are five times more at risk for eclampsia compared to maternal with preeclampsia without complications. Maternal who have severe preeclampsia accompanied by HELLP are two times more at risk of having labor under 34 weeks or preterm compared to maternal with preeclampsia without complications. Other outcomes, including maternal mortality, DIC, acute renal failure, pulmonary edema, antepartum hemorrhage, as well as perinatal mortality, FGR, IUFD, and perinatal asphyxia, did not show a statistically significant difference in proportion (p > 0.05).
Conclusion: There is a relationship between maternal and perinatal outcomes in severe preeclampsia without complications or with HELLP syndrome.

Perbandingan Luaran Maternal dan Perinatal antara Preeklamsia Berat Tanpa Penyulit dan dengan Sindrom HELLP

Abstrak
Pendahuluan: Luaran maternal dan perinatal pada kondisi preeklamsia berat, tanpa dan dengan sindrom HELLP, tergolong bervariasi. Saat ini masih minim data penelitian di Indonesia yang membandingkan hasil luaran maternal dan perinatal pada kedua kondisi tersebut. Penelitian ini bertujuan untuk mengetahui perbandingan luaran kehamilan antara preeklamsia berat tanpa komplikasi dan preeklamsia berat dengan Sindrom HELLP.
Metode: Metode yang digunakan dalam penelitian ini adalah analitik observasional dengan desain potong lintang retrospektif. Sampel penelitian ini adalah 92 pasien dari rekam medis pasien yang didiagnosis preeklamsia tanpa komplikasi dan preeklamsia berat dengan Sindrom HELLP di Rumah Sakit Hasan Sadikin Bandung pada periode Januari 2021 hingga Desember 2023.
Hasil: Hasil penelitian menunjukkan bahwa ibu dengan sindrom HELLP berisiko lima kali lebih besar untuk mengalami eklampsia dibandingkan dengan ibu dengan preeklampsia tanpa komplikasi. Ibu yang mengalami preeklampsia berat disertai HELLP berisiko dua kali lebih besar untuk mengalami persalinan di bawah 34 minggu atau prematur dibandingkan dengan ibu yang mengalami preeklampsia tanpa komplikasi. Luaran lain seperti kematian ibu, DIC, gagal ginjal akut, edema paru, perdarahan antepartum dan juga kematian perinatal, FGR, IUFD, asfiksia perinatal tidak ada perbedaan proporsi yang bermakna secara statistik (p>0,05).
Kesimpulan: Terdapat hubungan luaran maternal dan perinatal antara preeklamsia berat tanpa komplikasi atau dengan sindrom HELLP.

Kata kunci: Luaran Maternal, Perinatal, Sindrom HELLP

Keywords

Maternal Outcomes; Perinatal; HELLP Syndrome

Full Text:

PDF

References

Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. Hypertension. 2018 Jul;72(1):24–43.

Ernawati E, Erliana E, Sulistono A, Joewono HT, Akbar MIA, Wicaksono B, et al. 53. Expectant management of severe preeclampsia in a developing country: Maternal outcomes and perinatal survival. Pregnancy Hypertens. 2018 Oct;13:S19.

Lisonkova S, Joseph KS. Incidence of pre- eclampsia: risk factors and outcomes associ- ated with early- versus late-onset disease. Am J Obstet Gynecol . 2013;209(544):1–12.

Khalid F, Mahendraker N, Tonismae T. HELLP Syndrome. 2023.

P WA, Ernawati E, Susanti D. Characteristics of HELLP Syndrome in Severe Preeclampsia Patients in Dr. Soetomo Hospital Surabaya. Folia Medica Indonesiana. 2016 Nov 15;51(4):272.

Pribadi A, Hidayat D, Sasotya RMS, Aziz MA, Nurdiawan W, Pramatirta AY, et al. Assessing the Impact of the Zero Mother Mortality Preeclampsia Program on Maternal Mortality Rates at a Single Center in Bandung, West Java (2015-2022): A Retrospective Study. Medical Science Monitor. 2023 Jun 27;29.

Sungkar A, Irwinda R, Surya R, Krniawan AP. Maternal Characteristics, Pregnancy, and Neonatal Outome in Preeclampsia and HELLP Syndrome: a Comparative Study. eJournal Kedokteran Indonesia. 2021 Mar;

Kongwattanakul K, Saksiriwuttho P, Chaiyarach S, Thepsuthammarat K. Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and HELLP syndrome. Int J Womens Health. 2018 Jul;Volume 10:371–7.

Cunningham FG GN et al. Williams Obstetric. 26th ed. McGraw-Hill, editor. Medical Publishing Division; 2022.

T AN, Dewantiningrum J. Perbedaan Luaran Maternal dan Perinatal antara Preeklampsia Berat dengan Sindrom HELLP dan Sindrom HELLP Parsial. Vol. 6, Julian Dewantiningrum JKD. 2017.

Badani J, Tanra AH, Muchtar F. Treatment of HELLP Syndrome with Complications of Acute Kidney Injury (AKI) and Fluid Overload. Vol. 4, Jurnal Medical Profession (MedPro). 2022.

Kjell Haram, Einar Svendsen, Ulrich Abildgaard. The HELLP syndrome: Clinical issue and management. A Review. BMC Pregnancy and Chilbirth 2009. 2009;

Vigil‐De Gracia P. Pregnancy complicated by pre‐eclampsia–eclampsia with HELLP syndrome. International Journal of Gynecology & Obstetrics. 2001 Jan 2;72(1):17–23.

Aslan H, Gul A, Cebeci A. Neonatal Outcome in Pregnancies after Preterm Delivery for HELLP Syndrome. Gynecol Obstet Invest. 2004;58(2):96–9.

Abramovici D, Friedman SA, Mercer BM, Audibert F, Kao L, Sibai BM. Neonatal outcome in severe preeclampsia at 24 to 36 weeks’ gestation: Does the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome matter? Am J Obstet Gynecol. 1999 Jan;180(1):221–5.

Raval DS, Co S, Reid MA, Pildes R. Maternal and neonatal outcome of pregnancies complicated with maternal HELLP syndrome. J Perinatol. 1997;17(4):266–9.

Sumarni. Keluaran Maternal dan Neonatal pada Ibu Hamil dengan Sindrom HELLP di RS Margono Soekardjo Purwokrto . Jurnal Bidan Prada. 2019 Jun 30;

Nurokhim A, & WW. Analisis Preeklampsia Berat (Peb) dengan Kejadian Pertumbuhan Janin Terhambat (PJT) Di RSUD Dr. R. Goeteng Tarunadibrata Purbalingga Periode Tahun 2013-2015. 2019;

DOI: http://dx.doi.org/10.24198/obgynia.v7i2.719