The apartness of HELLP-syndrome from preeclampsia: features of damage of kidney and other organs


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Abstract

Background. In recent years, an alarming trend in obstetrics has been noted: an increase in ma-ternal mortality from pre-eclampsia (PE) and its complications is recorded annually, despite the optimization of methods for early diagnosis and approaches to delivery. It is believed that HELLP syndrome complicates 0.8-1% of pregnancies, and in severe PE and eclampsia occurs in 10-20% of cases. Various options and features of the manifestations of HELLP syndrome are little known to doctors. Material and methods. The course and outcome of pregnancies were studied in 141 women di-vided into 4 main groups: HELLP syndrome, severe pre-eclampsia (PE), moderate PE, and the control group. The main laboratory, clinical, biochemical, and immunological parameters, includ-ing imbalance of placental angiogenesis factors (sFlt-1, PLGF), as well as instrumental mrthods of diagnosis, were performed, and results were compared. Results. The sFlt-1/PLGF ratio in women with HELLP syndrome (Mo 254±93.51 pg/mL) was found to be significantly lower than in patients with severe (Mo 439.08±112.29) and moderate PE (306, 62±164.59). In addition to liver damage, almost all patients had signs of involvement of other organs in the pathological process, while renal failure was more pronounced compared with patients with PE (Mo serum creatinine in HELLP syndrome 110.80±20.62 MMOL/L, in SE-VERE PE 73,26±4.55 MMOL/L, and in moderate PE 71.73±6.16 MMOL/L). Conclusion. Probably, HELLP syndrome is not a more severe variant of PE. HELLP syndrome is a clinically manifest variant of thrombotic microangiopathy. It appears that PE is only a trigger for the development of HELLP syndrome.

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About the authors

T. V Kirsanova

FSBI "National Medical Research Center of Obstetrics, Gynecology and Perinatology N.A. Acad. V.I. Kulakov” of the Ministry of Health of the Russian Federation

Email: a_tatya@mail.ru
PhD in Medical Sciences, Senior Researcher at the Department of Reproductive Hematology and Clinical Hemostasiology

M. A Vinogradova

FSBI "National Medical Research Center of Obstetrics, Gynecology and Perinatology N.A. Acad. V.I. Kulakov” of the Ministry of Health of the Russian Federation

PhD in Medical Sciences, Hematologist, Head of the Department of Reproductive Hematology and Clinical Hemostasiology

A. I Kolyvanova

M.V. Lomonosov Moscow State University

Applicant of the Department of Internal Diseases, Faculty of Fundamental Medicine

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