Entrar/Registro  
INICIO ENGLISH
 
Revista Biomédica
   
MENÚ

Contenido por año, Vol. y Num.

Índice de este artículo

Información General

Instrucciones para Autores

Mensajes al Editor

Directorio






>Revistas >Revista Biomédica >Año 2018, No. 2


Bracamonte-Peniche J, López-Bolio V, Mendicuti-Carrillo M, Ponce-Puerto JM, Sanabrais-López MJ, Méndez-Domínguez N
Características clínicas y fisiológicas del síndrome de Hellp
Rev Biomed 2018; 29 (2)

Idioma: Español
Referencias bibliográficas: 69
Paginas: 33-41
Archivo PDF: 255.76 Kb.


Texto completo




RESUMEN

El síndrome de HELLP es una complicación multisistémica del embarazo que se distingue por el trastorno hipertensivo más la triada: Hemólisis microangiopática, elevación de enzimas hepáticas y disminución del conteo de plaquetas. Está asociado con la aparición de graves complicaciones perinatales e incremento de la mortalidad materna. Ocurre en 0,5 a 0,9% de todos los embarazos y en 10 a 20% de las pacientes con preeclampsia-eclampsia. Complicaciones obstétricas como ésta pueden pasarse por alto en la práctica clínica, generando situaciones de alto riesgo tanto para la madre como para el embrión, por lo que debe tenerse en cuenta su sintomatología y semiología dadas las dificultades en el diagnóstico diferencial.


Palabras clave: Síndrome de HELLP, Trastorno Hipertensivo, Hemólisis, Perinatal, Mortalidad Materna, Preeclampsia, Eclampsia.


REFERENCIAS

  1. Gutiérrez Aguirre CH, Alatorre-Ricardo J, Cantú Rodríguez O, Gómez Almaguer D. Síndrome de Hellp, diagnóstico y tratamiento. Rev Hematol Mex. 2012 Sep. 13(4):195-200. Disponible en: http://www.medigraphic. com/pdfs/hematologia/re-2012/re124h.pdf

  2. Weinstein L. It has been a great ride: The history of HELLP syndrome. American Am J Obstet Gynaecol. 2005 Sep. 193(3):860-3. https://doi.org/10.1016/j. ajog.2005.06.058.

  3. Miranda M, Vallejo-Vaz A, Cerrillo L, Marenco M, Villar J, Stiefel P. The HELLP syndrome (hemolysis, elevated liver enzymes and low platelets): Clinical characteristics and maternal–fetal outcome in 172 patients. Pregnancy Hypertens. 2011 Abr. 1(2):164-9. https://doi.org/10.1016/j.preghy.2011.01.004

  4. Parra-Ramírez P, Beckles-Maxwell M. Diagnóstico y manejo oportuno del síndrome de HELLP. Acta Médica Costarricense. 2005 Ene. 47(1):07-14. Disponible en: http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pi d=S0001-60022005000100002

  5. Rivas-Perdomo EE, Mendivil-Ciódaro CO. Síndrome de Hellp: Revisión. Salud Uninorte. 2011 Juldic. 27(2). Disponible en: http://www.redalyc.org/ html/817/81722541010/

  6. Vigil-De Gracia P, Rojas-Suarez J, Ramos E, Reyes O, Collantes J, Quintero A, et al. Incidence of eclampsia with HELLP syndrome and associated mortality in Latin America. Intl J Gynecol Obst. 2015 Jun. 129(3):219-22. https://doi.org/10.1016/j.ijgo.2014.11.024

  7. Dirección General de Epidemiología. Hemorragia Obstétrica. México: Secretaría de Salud; 2017 Dic. 34(50). Disponible en: https://www.gob.mx/ salud/acciones-y-programas/direccion-general-deepidemiologia- boletin-epidemiologico

  8. Salazar C, Negreros A, Díaz I, Garrido E. Morbimortalidad materna del síndrome de HELLP en Yucatán. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva. 2005 Mar. 2(19):45-49. Disponible en: http:// www.medigraphic.com/pdfs/medcri/ti-2005/ti052a.pdf

  9. Díaz MI, de Castro Parga G, Eiras MF, Barreiro GF, Cardamas PD, Naveira EC, et al. Tratamiento quirúrgico conservador del síndrome de HELLP (ELLP) asociado a hematoma hepático subcapsular. Clin Invest Ginecol Obstet. 2013 Jul-Ago. 40(4):189-92. https://doi. org/10.1016/j.gine.2012.10.002

  10. López Gómez JR, Rivs M, Colmenares B, Alvarado S, Silva D, Capretta D. Síndrome HELLP en la Maternidad del Hospital “Dr. Adolfo Prince Lara”. Rev Obstet Ginecol Venez. 2001 Sep. 61(2):77-81. Disponible en: http://www.scielo.org.ve/scielo.php?pid=S0048- 77322001000200002&script=sci_arttext&tlng=pt

  11. De la Rubia J, Pérez F, Navarro A. Síndrome HELLP. Medicina clínica. 2001 Mar. 117(2):64-8. https://doi. org/10.1016/S0025-7753(01)72014-3

  12. Castillo González DC. Síndrome HELLP: Actualización. Revista Cubana de Hematología, Inmunología y Hemoterapia. 2007 Abr. 23(1) Disponible en: http:// scielo.sld.cu/scielo.php?script=sci_arttext&pid =S0864-02892007000100003

  13. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A Review. BMC pregnancy childbirth. 2009 Feb. 9(1):8. https://doi. org/10.1186/1471-2393-9-8

  14. Bu S, Wang Y, Sun S, Zheng Y, Jin Z, Zhi J. Role and mechanism of AT1-AA in the pathogenesis of HELLP syndrome. Sci Rep. 2018 Ene. 8(1):279. doi:10.1038/ s41598-017-18553-x

  15. Cuffe JS, Holland O, Salomon C, Rice GE, Perkins AV. Placental derived biomarkers of pregnancy disorders. Placenta. 2017 Ago. 54:104-10. https://doi.org/10.1016/j. placenta.2017.01.119

  16. Pan Q, Niu H, Cheng L, Li X, Zhang Q, Ning Y. Invasion of trophoblast cell lines is inhibited by miR-93 via MMP-2. Placenta. 2017 May. 53:48-53. https://doi. org/10.1016/j.placenta.2017.03.008

  17. Giachini FR, Galaviz-Hernandez C, Damiano AE, Viana M, Cadavid A, Asturizaga P, et al. Vascular Dysfunction in Mother and Offspring During Preeclampsia: Contributions from Latin-American Countries. Curr Hypertens Rep. 2017 Oct. 19(10):83. https://doi. org/10.1007/s11906-017-0781-7

  18. Ramadan MK, Badr DA, Hubeish M, Itani S, Hijazi H, Mogharbil A. HELLP Syndrome, Thrombotic Thrombocytopenic Purpura or Both: Appraising the Complex Association and Proposing a Stepwise Practical Plan for Differential Diagnosis. J Hematol. 2018 Ene. 7(1):32-7. doi: https://doi.org/10.14740/jh347w

  19. Burton G, Woods A, Jauniaux E. Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta. 2009 Jun. 30(6):473- 82. https://doi.org/10.1016/j.placenta.2009.02.009

  20. Yilmaz Z, Voyvoda N, Sirinocak P, Terzi H. Association of hemolysis, elevated liver enzymes, low platelets syndrome with posterior reversible encephalopathy and intracranial hypotension. Neurol India. 2018 Ene-Feb. 66(1). https://doi.org/10.4103/0028-3886.222856

  21. Doshi S, Zucker SD. Liver emergencies during pregnancy. Gastroenterol Clin N Am. 2003 Dic. 32(4):1213-27. https://doi.org/10.1016/S0889-8553(03)00096-7

  22. Barton JR, Riely CA, Adamec TA, Shanklin DR, Khoury AD, Sibai BM. Hepatic histopathologic condition does not correlate with laboratory abnormalities in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). Am J of obst gynecol. 1992 Dic. 167(6):1538-43. https://doi.org/10.1016/0002- 9378(92)91735-S

  23. Sibai BM, Ramadan MK, Chri RS, Friedman SA. Pregnancies complicated by HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): subsequent pregnancy outcome and long-term prognosis. American J Obstet Gynecol. 1995 Ene. 172(1):125-9. https://doi.org/10.1016/0002-9378(95)90099-3

  24. Knapen MF, Altena AM, Peters WH, Merkus HM, Jansen JB, Steegers EA. Liver function following pregnancy complicated by the HELLP syndrome. BJOG. 1998 Nov. 105(11):1208-10. https://doi. org/10.1111/j.1471-0528.1998.tb09977.x

  25. Aloizos S, Seretis C, Liakos N, Aravosita P, Mystakelli C, Kanna E, et al. HELLP syndrome: understanding and management of a pregnancy-specific disease. J Obstet Gynaecol. 2013 May. 33(4):331-7. https://doi.org/10.31 09/01443615.2013.775231

  26. Baxter JK, Weinstein L. HELLP syndrome: the state of the art. Obstet gynecol surv. 2004 Dic. 59(12):838-45. https://doi.org/10.1097/01.ogx.0000146948.19308.c5

  27. Cavkaytar S, Ugurlu EN, Karaer A, Tapisiz OL, Danisman N. Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? Acta Obstet Gynecol Scand. 2007 Jun. 86(6):648-51. https://doi. org/10.1080/00016340601185384

  28. Yadav DK, Shah AK. HELLP Syndrome: A brief Review. JBPR. 2017 Mar-Abr. 6(2). Disponible en: http://jbpr.in/ index.php/jbpr/article/view/67/59

  29. Gracia VD. Síndrome HELLP. Ginecol Obstet Mex. 2015 Ene. 83(1). Disponible en: http://www.medigraphic. com/pdfs/ginobsmex/gom-2015/gom151g.pdf

  30. Rezai S, Faye J, Hughes A, Cheung M-L, Cohen JR, Kaia JA, et al. Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review. Case Rep Obstet Gynecol. 2017 Abr. 2017. https://doi. org/10.1155/2017/8481290

  31. Ditisheim A, Sibai BM. Diagnosis and management of HELLP syndrome complicated by liver hematoma. Clin Obstet Gynecol. 2017 Mar. 60(1):190-7. https://doi. org/10.1097/GRF.0000000000000253

  32. Chowdhury MAK, Huq NL, Khanom A, Islam R, Khan ANS, Karim F, et al. Quality of Care for the Maternal Complications at Selected Primary and Secondary Health Facilities of Bangladesh: Lessons Learned from a Formative Research. Int J Med Health Sci. 2018 May. 5(6). Disponible en: https://waset.org/abstracts/medicaland- health-sciences/80997

  33. Cararach Ramoneda V, Botet Mussons F. Preeclampsia. Eclampsia y síndrome HELLP Institut Clinic de Ginecología Obstetricia y Neonatología Hospital Clinic de Barcelona. 2008:139-40. Disponible en: https://www. aeped.es/sites/default/files/documentos/16_1.pdf

  34. Abildgaard U, Heimdal K. Pathogenesis of the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP): a review. Eur J Obstet Gynecol. 2013 Feb. 166(2):117-23. https://doi.org/10.1016/j. ejogrb.2012.09.026

  35. Sibai BM. The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol. 1990 Feb.162(2):311-6. https://doi.org/10.1016/0002-9378(90)90376-I

  36. Martin JN, Rose CH, Briery CM. Understanding and managing HELLP syndrome: the integral role of aggressive glucocorticoids for mother and child. Am J Obstet Gynecol. 2006 Oct. 195(4):914-34. https://doi. org/10.1016/j.ajog.2005.08.044

  37. Gedik E, Yücel N, Sahin T, Koca E, Colak YZ, Togal T. Hemolysis, elevated liver enzymes, and low platelet syndrome: Outcomes for patients admitted to Intensive Care at a tertiary referral hospital. Hypertens Pregnancy. 2017 Feb. 36(1):21-9. https://doi.org/10.1080/10641955 .2016.1218505

  38. Zatelli M, Comai A. Spontaneous rupture of the liver in a patient admitted for subarachnoid hemorrhage. Int J Surg Case Rep. 2015. 6:15-8. https://doi.org/10.1016/j. ijscr.2014.10.016

  39. Llovera I, Roit Z, Johnson A, Sherman L. Cortical blindness, a rare complication of pre-eclampsia. J Emerg Med. 2005 Jun. 29(3):295-7. https://doi.org/10.1016/j. jemermed.2005.03.008

  40. Block HS. Neurological complications of pregnancy. Curr Neurol Neurosci Rep. 2016 Jul. 16(7):67. https:// doi.org/10.1007/s11910-016-0665-2

  41. Martin JN, Rinehart BK, May WL, Magann EF, Terrone DA, Blake PG. The spectrum of severe preeclampsia: comparative analysis by HELLP (hemolysis, elevated liver enzyme levels, and low platelet count) syndrome classification. Am J Obstetrics Gynecol. 1999 Jun. 180(6):1373-84. https://doi.org/10.1016/S0002- 9378(99)70022-0

  42. Hay JE. Liver disease in pregnancy. Hepatology. 2008 Mar. 47(3):1067-76.

  43. 43. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA. Liver disease in pregnancy. Lancet. 2010 Feb. 375(9714):594-605. https://doi.org/10.1016/S0140- 6736(09)61495-1

  44. Aranas RM, Prabhakaran S, Lee VH. Posterior reversible encephalopathy syndrome associated with hemorrhage. Neurocrit Care. 2009 Feb. 10(3):306-12. https://doi. org/10.1007/s12028-009-9200-5

  45. Shah A. Non-aneurysmal primary subarachnoid hemorrhage in pregnancy-induced hypertension and eclampsia. Neurology. 2003 Mar. 61(1):117-20. https:// doi.org/10.1212/01.WNL.0000069609.36517.A3

  46. Robinson JL, Hall CJ, Sedzimir CB. Subarachnoid hemorrhage in pregnancy. Journal of neurosurgery. 1972 Ene. 36(1):27-33. http://thejns.org/doi/abs/10.3171/ jns.1972.36.1.0027

  47. Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clin Perinatol. 2004 Dic. 31(4):807-33. http:// thejns.org/doi/abs/10.3171/jns.1972.36.1.0027

  48. Katz L, de Amorim MMR, Figueiroa JN, e Silva JLP. Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstetr Gynecol. 2008 Mar. 198(3):283. e1-e8. ttps://doi.org/10.1016/j. ajog.2007.10.797

  49. Erkurt MA, Berber I, Berktas HB, Kuku I, Kaya E, Koroglu M, et al. A life-saving therapy in Class I HELLP syndrome: Therapeutic plasma exchange. Transfus Sci. 2015 Abr. 52(2):194-8. https://doi.org/10.1016/j. transci.2014.12.026

  50. Mecacci F, Carignani L, Cioni R, Parretti E, Mignosa M, Piccioli A, et al. Time course of recovery and complications of HELLP syndrome with two different treatments: heparin or dexamethasone. Thromb Res. 2001 Abr. 102(2):99-105. https://doi.org/10.1016/ S0049-3848(01)00234-1

  51. Fitzpatrick KE, Hinshaw K, Kurinczuk JJ, Knight M. Risk factors, management, and outcomes of hemolysis, elevated liver enzymes, and low platelets syndrome and elevated liver enzymes, low platelets syndrome. Obstet Gynaecol. 2014 Mar. 123(3):618-27. https://doi. org/10.1097/AOG.0000000000000140

  52. ElFarra J, Bean C, Martin JN. Management of hypertensive crisis for the obstetrician/gynecologist. Obstet Gynaecol Clin. 2016 Dic. 43(4):623-37. https:// doi.org/10.1016/j.ogc.2016.07.005

  53. Barnhart L. HELLP Syndrome and the Effects on the Neonate. Neonatal Network. 2015 Sep. 34(5):269-73. https://pdfs.semanticscholar.org/0fa1/6ffc596e86d0153d 691327ed21961399a33d.pdf

  54. Almuna V, Valdés F, Ramírez F, Barrera C, Bakal I, Montoya C. Eficacia de la dexametasona en síndrome HELLP. Rev Chil Obstet Ginecol. 2003. 68(6):508-12. http://dx.doi.org/10.4067/S0717-75262003000600010

  55. Restrepo CA, Márquez E, Sanz MF. Plasmaféresis terapéutica, tipos, técnica e indicaciones en medicina interna. Acta Med Colomb. 2009 Ene- Mar. 34(1). Disponible en: http://www.redalyc.org/ html/1631/163113823005/

  56. Rahman T, Wendon J. Severe hepatic dysfunction in pregnancy. Qjm. 2002 Jun. 95(6):343-57. https://doi. org/10.1093/qjmed/95.6.343

  57. Magann EF, Martin Jr JN. Twelve steps to optimal management of HELLP syndrome. Clin Obstet Gynecol. 1999 Sep. 42(3):532. http://dx.doi. org/10.1097/00003081-199909000-00009

  58. Habli M, Eftekhari N, Wiebracht E, Bombrys A, Khabbaz M, How H, et al. Long-term maternal and subsequent pregnancy outcomes 5 years after hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. Am J Obstet Gynecol 2009 Oct. (4):385. e1-e5. https:// doi.org/10.1016/j.ajog.2009.06.033

  59. O’brien JM, Barton JR. Controversies with the diagnosis and management of HELLP syndrome. Clin Obstet Gynecol. 2005 Jun. 48(2):460-77. doi: 10.1097/01. grf.0000160309.73197.35

  60. Sep S, Verbeek J, Koek G, Smits L, Spaanderman M, Peeters L. Clinical differences between early-onset HELLP syndrome and early-onset preeclampsia during pregnancy and at least 6 months postpartum. American Journal of Obstetrics & Gynecology. 2010 Mar. 202(3):271. e1-e5.

  61. Ellison J, Greer IA, Sattar N. HELLP syndrome: mechanisms and management. Hosp Med. 1999 Apr. 60(4):243-9. https://doi.org/10.12968/ hosp.1999.60.4.1089

  62. Egerman RS, Sibai BM. HELLP syndrome. Clin Obstet Gynecol. 1999 Jun. 42(2):381-9. PMID: 10370856

  63. Hupuczi P, Rigó B, Sziller I, Szabó G, Szigeti Z, Papp Z. Follow-up analysis of pregnancies complicated by HELLP syndrome. Fetal Diagn Ther. 2006 Nov. 21(6):519-22. https://doi.org/10.1159/000095665

  64. Mallick IH, Syed SA, Kar AK. Liver rupture following delivery: HELLP needed. Emerg Med J. 2007 May. 24(5):372. http://dx.doi.org/10.1136/emj.2006.044735

  65. Pliego AP, Zavala JS, Rodríguez RB, Martínez JHF, Porras AJ. Spontaneous hepatic rupture of pregnancy. A report of four cases and medical literature review. Ginecol Obstet Mex. 2006 Apr. 74(4):224-31. PMID: 16886770

  66. Vignolo J, Vacarezza M, Álvarez C, Sosa A. Niveles de atención, de prevención y atención primaria de la salud. Arch Med Intern. 2011 Mar. 33(1):7-11. Disponible en: http://www.scielo.edu.uy/scielo.php?pid=S1688- 423X2011000100003&script=sci_arttext

  67. Seren G, Morel J, Jospe R, Mahul P, Dumont A, Cuileron M, et al., editors. HELLP syndrome and ruptured subcapsular hepatic haematoma. Case report and therapeutic options. Ann Fr Anesth Reanim. 2006 Oct. 25(10): 1067-1069. https://doi.org/10.1016/j. annfar.2006.07.077

  68. Díaz-Martínez LA, Serrano-Díaz NC. Oportunidades de investigación en preeclampsia, desde la perspectiva de prevención primaria. Un artículo de reflexión. Rev Colomb Obstet Ginecol. 2008 Ago. 59(3). Disponible en: http://www.redalyc.org/html/1952/195214332005/

  69. Rath, Werner, Andree Faridi and Joachim W. Dudenhausen. 2005. HELLP Syndrome. J Perinat Med. 28(4): 249-260. https://doi.org/10.1515/JPM.2000.033.



>Revistas >Revista Biomédica >Año2018, No. 2
 

· Indice de Publicaciones 
· ligas de Interes 






       
Derechos Resevados 2019