First trimester prediction of HELLP syndrome

Natacha Oliveira, Liona C. Poon, Kypros H. Nicolaides, Ahmet A. Baschat

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The aim of this study was to evaluate first-trimester maternal characteristics and biomarkers in pregnancies that subsequently develop HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Method: Maternal history, biochemical, and biophysical parameters were compared between women who developed HELLP, preeclampsia (PE) without HELLP and controls. After determination of significant variables through univariate analysis a first-trimester prediction model was obtained by applying logistic regression analysis. Performance of the model was evaluated. Results: Twenty participants with HELLP were compared with 147 patients that developed PE without HELLP and 2810 controls. Women with HELLP were more likely Caucasian, nulliparous and presented a higher mean arterial pressure (MAP) when compared with controls. As opposing to women who developed HELLP, women who developed PE without HELLP were more likely of African-American origin and presented an even higher first-trimester MAP. Enrollment biochemical and biophysical parameters were similar between HELLP and PE or controls. Ethnicity, nulliparity, history of previous PE, history of previous HELLP syndrome, and first-trimester MAP were primary risk factors. A prediction rule for HELLP syndrome had an area under the curve of 0.80, with 75% sensitivity for 79% specificity. Conclusion: The majority of pregnancies that develop HELLP syndrome can be predicted in the first trimester.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalPrenatal Diagnosis
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Genetics(clinical)

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