Last update 21 Mar 2024

HELLP Syndrome

Last update 21 Mar 2024

Basic Info

Synonyms

HELLP, HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, HELLP - Syndrome of haemolysis, elevated liver enzymes and low platelet

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Introduction

A syndrome of HEMOLYSIS, elevated liver ENZYMES, and low blood platelets count (THROMBOCYTOPENIA). HELLP syndrome is observed in pregnant women with PRE-ECLAMPSIA or ECLAMPSIA who also exhibit LIVER damage and abnormalities in BLOOD COAGULATION.

Clinical Trials associated with HELLP Syndrome

NCT05847361 / CompletedNot ApplicableIIT

Can bh4 Levels Predict Severity and Complications of Pre Eclampsia in Pregnant Women

tetrahydrobiopterin (BH4) is degraded by several enzymes, including BH4 oxidase and peroxidases. Several factors can affect its synthesis and degradation. BH4 deficiency or depletion and genetic variations in the genes involved in BH4 metabolism have been associated with hypertension, suggesting that BH4 may play a role in the pathogenesis of hypertension.
The maternity center of Tunis ( CMNT ) is a level 3 maternity center, supporting over 12 000 births yearly, where the caesarean section's rate is very high, close to 45% of deliveries.
Early detection of these patients can help control maternal and neonatal safety outcomes. we can avoid complications such as severe preeclampsia, HELLP syndrom and eclampsia for the mother, and preterm delievery and fetal growth restriction for the new born.
in the literature, studies have reported a decrease in BH4 levels in pregnant women compared to non-pregnant women and others showed that its deficiency or depletion has been associated with hypertension. Moreover, tetrahydrobiopterin administration has been studied as a potential treatment for preeclampsia but the optimal dose has not yet been determined, and further studies are needed to determine the appropriate dose, timing, and duration of BH4 supplementation in this context.
Thus, BH4 blood levels as a mean of screening, could enrich our diagnostic arsenal. The purpose of our study is to compare BH4 levels between preeclamptic and normotensive women.

Start Date15 Mar 2023

Sponsor / Collaborator

University of Tunis El Manar

NCT04725812 / TerminatedPhase 2IIT

Complement Regulation to Undo Systemic Harm in Preeclampsia: The CRUSH Study

This is a Phase II, single arm, open-label study to determine if treatment with eculizumab prolongs pregnancy compared to historical controls in women with preeclampsia between 23-30 weeks gestation.

Start Date13 Sep 2021

Sponsor / Collaborator

Cedars-Sinai Medical Center

[+1]

NCT06074601 / Active, not recruitingNot Applicable

Observational Study of Pregnant People to Validate Biomarkers of Pregnancy Complication Risk

The goal of this observational study is to develop and validate cell-free RNA-based biomarkers for predicting a variety of adverse pregnancy outcomes in a pregnant person population. The main question it aims to answer are:
1. Can cell-free RNA-based biomarkers predict which pregnant people are at greatest risk of developing adverse pregnancy outcomes (e.g., preterm birth, preeclampsia)?
2. What is the performance of such biomarkers when predicting an adverse pregnancy outcome (e.g., sensitivity, specificity, PPV, NPV, TPR)?

Start Date01 Aug 2021

Sponsor / Collaborator

Mirvie, Inc.Startup

100 Clinical Results associated with HELLP Syndrome

100 Translational Medicine associated with HELLP Syndrome

0 Patents (Medical) associated with HELLP Syndrome

2,647

Literatures (Medical) associated with HELLP Syndrome

17 Feb 2024·Gynecologie, obstetrique, fertilite & senologie

[Maternal Deaths due to hypertensive disorders in France, 2016-2018].

Author: Michel Dreyfus ; Agnès Rigouzzo ; Marie Jonard

Between 2016 and 2018, 13 maternal deaths were due to hypertensive disorders. During this period, the maternal mortality ratio was 0.6/100 000 live births. Hypertensive disorders were responsible for 4.8 % of maternal deaths during the first year, 5.1 % up to 42 days postpartum and for 13.5 % of direct maternal mortality. Maternal deaths due to hypertensive disorders increased close to signification (p = 0.09) compared to the last triennium (MMR = 0.2/100.000). Classification of the hypertensive disorders was : 5 severe preeclampsia, 3 eclampsia, 4 HELLP syndromes et 1 undefined hypertension. In five cases, a stroke was associated. Mode of delivery was a cesarean section when the hypertensive disorder started before the labour (8/13, 62%). Six women were older than 35 years old and 5/12 were nulliparous. Among the 12 cases where place of birth was known, 5 were born foreigners. Une obésité était présente dans 46% des cas. BMI was over 30 for 46%. Medical care were estimated non optimal in 11/13 of the cases. Among these deaths, 66 % (8/12) seemed to be preventable versus 82 % for the last period 2013-2015. The main causal factor of suboptimal management was unappropriate management by the obstetrical or anesthetist/intensive care squads, respectively: 3 lack of diagnosis, 8 delays for diagnosis and 5 underestimated severity. Four cases corresponded to unappropriated health care organization. Ceci confirme que les complications hypertensives de la grossesse ont un pourcentage d'évitabilité élevé ce qui laisse une grande marge d'amélioration dans leur prise en charge. This study offers the opportunity to stress major points to optimize medical management and health care organization facing hypertensive disorders during pregnancy.

06 Feb 2024·Journal of intensive care medicine

Clinical Characteristics, Outcomes, and Risk Factors for Mortality in Pregnant/Puerperal Women with COVID-19 Admitted to ICU in Turkey: A Multicenter, Retrospective Study from a Middle-Income Country.

Article

Author: Nur Baykara ; PREGCOVID-ICU study group

BACKGROUND:

Coronaviruses have been the cause of 3 major outbreaks during the last 2 decades. Information on coronavirus diseases in pregnant women is limited, and even less is known about seriously ill pregnant women. Data are also lacking regarding the real burden of coronavirus disease 2019 (COVID-19) infection in pregnant women from low/middle-income countries. The aim of this study was to determine the characteristics and clinical course of COVID-19 in pregnant/puerperal women admitted to ICUs in Turkey.

METHODS:

This was a national, multicenter, retrospective study. The study population comprised all SARS-CoV-2-infected pregnant/puerperal women admitted to participating ICUs between 1 March 2020 and 1 January 2022. Data regarding demographics, comorbidities, illness severity, therapies, extrapulmonary organ injuries, non-COVID-19 infections, and maternal and fetal/neonatal outcomes were recorded. LASSO logistic regression and multiple logistic regression analyses were used to identify predictive variables in terms of ICU mortality.

RESULTS:

A total of 597 patients (341 pregnant women, 255 puerperal women) from 59 ICUs in 44 hospitals were included and of these patients, 87.1% were unvaccinated. The primary reason for ICU admission was acute hypoxemic respiratory failure in 522 (87.4%), acute hypoxemic respiratory failure plus shock in 14 (2.3%), ischemic cerebrovascular accident (CVA) in 5 (0.8%), preeclampsia/eclampsia/HELLP syndrome in 6 (1.0%), and post-caesarean follow-up in 36 (6.0%). Nonsurvivors were sicker than survivors upon ICU admission, with higher APACHE II (p < 0.001) and SOFA scores (p < 0.001). A total of 181 (30.3%) women died and 280 (46.6%) had received invasive mechanical ventilation (IMV). Myocardial injury, the highest SOFA score during ICU stay, LDH levels on admission, the highest levels of AST during ICU stay, average daily dose of corticosteroids, IMV, prophylactic dose anticoagulation (compared with therapeutic dose anticoagulation), PaO₂/FiO₂ ratio <100, pulmonary embolism, and shock were identified as predictors of mortality. Rates of premature birth (46.4%), cesarean section (53.7%), fetal distress (15.3%), stillbirth (6.5%), and low birth weight (19.4%) were high. Rates of neonatal death (8%) and respiratory distress syndrome (21%) were also high among live-born infants.

CONCLUSIONS:

Severe/critical COVID-19 infection during the pregnancy/puerperal period was associated with high maternal mortality and fetal/neonatal complication rates in Turkey.

06 Feb 2024·Diagnostics (Basel, Switzerland)

HELLP Syndrome and Differential Diagnosis with Other Thrombotic Microangiopathies in Pregnancy.

Review

Author: Stefano Raffaele Giannubilo ; Daniela Marzioni ; Giovanni Tossetta ; Andrea Ciavattini

Thrombotic microangiopathies (TMAs) comprise a distinct group of diseases with different manifestations that can occur in both pediatric and adult patients. They can be hereditary or acquired, with subtle onset or a rapidly progressive course, and they are particularly known for their morbidity and mortality. Pregnancy is a high-risk time for the development of several types of thrombotic microangiopathies. The three major syndromes are hemolysis, elevated liver function tests, and low platelets (HELLP); hemolytic uremic syndrome (HUS); and thrombotic thrombocytopenic purpura (TTP). Because of their rarity, clinical information and therapeutic results related to these conditions are often obtained from case reports, small series, registries, and reviews. The collection of individual observations, the evolution of diagnostic laboratories that have identified autoimmune and/or genetic abnormalities using von Willebrand factor post-secretion processing or genetic-functional alterations in the regulation of alternative complement pathways in some of these TMAs, and, most importantly, the introduction of advanced treatments, have enabled the preservation of affected organs and improved survival rates. Although TMAs may show different etiopathogenesis routes, they all show the presence of pathological lesions, which are characterized by endothelial damage and the formation of thrombi rich in platelets at the microvascular level, as a common denominator, and thrombotic damage to microcirculation pathways induces "mechanical" (microangiopathic) hemolytic anemia, the consumption of platelets, and ischemic organ damage. In this review, we highlight the current knowledge about the diagnosis and management of these complications during pregnancy.

News (Medical) associated with HELLP Syndrome

07 Mar 2024

·www.nsmedicaldevices.com

QuidelOrtho secures Health Canada approval for Triage PLGF test

Triage PLGF is a fluorescence immunoassay intended for use with the Triage MeterPro Instrument to determine placental growth factor (PLGF) in maternal plasma specimens, to detect the presence of angiogenic imbalance Triage PLGF test is a fluorescence immunoassay. (Credit: Louis Reed on Unsplash) US-based in-vitro diagnostic technologies provider QuidelOrtho has secured Health Canada approval for its Triage PLGF test for laboratory use in Canada. Triage PLGF is a fluorescence immunoassay intended for use with the Triage MeterPro Instrument to determine placental growth factor (PLGF) in maternal plasma specimens. The test detects the presence of angiogenic imbalance, a consequence of abnormal placentation and poor blood flow in the placenta. Angiogenic imbalance can lead to maternal and foetal complications of pregnancy, including serious high blood pressure (hypertension) disorder pre-eclampsia. The Triage PLGF test, together with other clinical information, helps diagnosis of preterm pre-eclampsia and the prognosis of short-term delivery in pregnant women. It is used in pregnant women presenting with signs and symptoms of pre-eclampsia after 20 weeks through 35 weeks of gestation. QuidelOrtho Canada country director Bernard Michaud said: “When signs or symptoms of pre-eclampsia are present, it is critical to the health and safety of the mother and her unborn baby that clinicians have the information necessary to determine the optimal course of action to achieve the best possible outcome for the pregnancy. “The Triage PLGF test is intended to help clinicians diagnose pre-eclampsia sooner and may provide them with information on whether the pregnancy is likely to deteriorate within the next 14 days, allowing for a better patient care management plan.” Angiogenic imbalance plays a key role in the pathophysiology of preterm pre-eclampsia. It also poses the risk for maternal complications, such as HELLP syndrome and eclampsia, and foetal complications, including prematurity and stillbirth. QuidelOrtho said that its Triage PLGF test will enable clinicians to better detect angiogenic imbalance and evaluate the risk for potential complications. The test delivers results within 15 minutes and provides superior accuracy to support the clinical diagnosis of pre-eclampsia needing delivery within 14 days. When integrated into a clinical management guideline, the test can facilitate quicker diagnosis and a 20% reduction in maternal adverse outcomes. QuidelOrtho said that, unlike other tests which measure two biomarkers on a larger laboratory analyser, the Triage PLGF test measures a single biomarker on the Triage MeterPro instrument.

Diagnostic ReagentsClinical Study

06 Mar 2024

·www.biospace.com

QuidelOrtho Receives Health Canada Approval for Quidel® Triage® PLGF Test for Laboratory Use in Canada

Aiding in the diagnosis of preterm pre-eclampsia and prognosis of delivery in symptomatic women SAN DIEGO--(BUSINESS WIRE)-- QuidelOrtho Corporation (Nasdaq:QDEL) (“QuidelOrtho”), a global provider of innovative in vitro diagnostic technologies designed for point-of-care settings, clinical labs and transfusion medicine, has received approval from Health Canada for its Triage PLGF test for laboratory use in Canada. The Triage PLGF test is a fluorescence immunoassay to be used with the small footprint Triage MeterPro® Instrument for the quantitative determination of placental growth factor (“PLGF”) in maternal plasma specimens. The test is intended to detect the presence of angiogenic imbalance, a consequence of abnormal placentation and poor blood flow in the placenta, which can lead to maternal and fetal complications of pregnancy, including pre-eclampsia.1 Pre-eclampsia is a serious disorder that affects up to 5 percent of pregnancies in Canada.2 The Triage PLGF test is used with other clinical information to aid in the diagnosis of preterm pre-eclampsia and in the prognosis of short-term delivery in women presenting with signs and symptoms of pre-eclampsia after 20 weeks and prior to 35 weeks of gestation. Diagnosis of pre-eclampsia indicates delivery within 14 days.3 “When signs or symptoms of pre-eclampsia are present, it is critical to the health and safety of the mother and her unborn baby that clinicians have the information necessary to determine the optimal course of action to achieve the best possible outcome for the pregnancy,” said Bernard Michaud, Country Director, Canada at QuidelOrtho. “The Triage PLGF test is intended to help clinicians diagnose pre-eclampsia sooner and may provide them with information on whether the pregnancy is likely to deteriorate within the next 14 days, allowing for a better patient care management plan.” Angiogenic imbalance plays a central role in the pathophysiology of preterm pre-eclampsia and places the pregnancy at risk for maternal complications, like HELLP syndrome and eclampsia, and fetal complications, like prematurity and stillbirth. With the Triage PLGF test, clinicians can be positioned to better detect angiogenic imbalance and assess the risk for these complications. The Society of Obstetricians and Gynecologists of Canada (SOGC) guidelines indicate the measurement of angiogenic markers, such as those detected by the Triage PLGF test, because of strong clinical evidence supporting their use to aid in the diagnosis of pre-eclampsia and prognosis for adverse pregnancy outcomes.4 The Triage PLGF test delivers results in approximately 15 minutes and provides high accuracy to support the clinical diagnosis of pre-eclampsia needing delivery within 14 days. When integrated into a clinical management guideline, the Triage PLGF test can lead to faster diagnosis and a 20% reduction in maternal adverse outcomes.5 The Triage PLGF test is unique because it measures a single biomarker on the Triage MeterPro instrument, unlike other tests which require two biomarkers measured on a larger-footprint laboratory analyzer. The Triage PLGF test is available to customers in Canada for use with the Triage MeterPro instrument. The Triage MeterPro instrument is easy to use with robust quality control and would be suitable for urban and rural laboratory settings, delivering Triage PLGF test results quickly. Resources: 1. Redman CWG, Sargent IL. Pre-eclampsia, the placenta and the maternal systemic inflammatory response—a review. Placenta. 2003;24 Suppl A:S21-7. doi:10.1053/plac.2002.0930 2. Ontario Health (Quality). Placental growth factor (PLGF)-based biomarker testing to help diagnose pre-eclampsia in people with suspected pre-eclampsia: A health technology assessment. Ont Health Technol Assess Ser. 2023;23(3):1-146. 3. Quidel Triage PLGF Pack Insert 4. Magee LA, Smith GN, Bloch C, et al. Guideline No. 426: Hypertensive disorders of pregnancy: Diagnosis, prediction, prevention, and management. J Obstet Gynaecol Can. 2022;44(5):547-571.e1. doi:10.1016/j.jogc.2022.03.002. PMID: 35577426 5. Duhig KE, Myers J, Seed PT, et al. Placental growth factor testing to assess women with suspected pre-eclampsia: a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial. Lancet. 2019;393(10183):1807-18. doi:10.1016/S0140-6736(18)33212-4 About QuidelOrtho Corporation QuidelOrtho Corporation (Nasdaq: QDEL) is a world leader in in vitro diagnostics, developing and manufacturing intelligent solutions that transform data into understanding and action for more people in more places every day. Offering industry-leading expertise in immunoassay and molecular testing, clinical chemistry and transfusion medicine, bringing fast, accurate and reliable diagnostics when and where they are needed – from home to hospital, lab to clinic. So that patients, clinicians and health officials can spot trends sooner, respond quicker and chart the course ahead with accuracy and confidence. Building upon its many years of groundbreaking innovation, QuidelOrtho continues to partner with customers across the healthcare continuum and around the globe to forge a new diagnostic frontier--one where insights and solutions know no bounds, expertise seamlessly connects and a more informed path is illuminated for each of us. QuidelOrtho is advancing diagnostics to power a healthier future. For more information, please visit . Source: QuidelOrtho Corporation

Diagnostic ReagentsClinical Study

08 Feb 2023

·www.biospace.com

New Preeclampsia Research Funded to Investigate Genetic Targets to Develop Potential Therapeutics

SAN FRANCISCO, Feb. 8, 2023 /PRNewswire/ -- The Preeclampsia Foundation announced today the recipient of its 2023 Peter Joseph Pappas Research Grants at the Society for Maternal Fetal Medicine 43rd Annual Pregnancy Meeting. Based on the recommendations of its Scientific Advisory Council, the Preeclampsia Foundation awarded a grant totaling $99,994 USD to Wendy Kuohung, MD of Boston University. Principal Investigator Wendy Kuohung, MD, and her project Characterization of apolipoprotein L1 (APOL1) variant-overexpressing cell lines for high-throughput drug screening, will be carried out at Boston University Chobanian & Avedisian School of Medicine. The study is designed to potentially accelerate discovery of therapies for preeclampsia by designing placental cell lines that express variants of the APOL1 gene for drug screening. Previous research has found that these variants in the APOL1 gene increase the risk of developing preeclampsia when present in the fetus and also alter levels of certain proteins in cells when expressed. The study aims to design a special assay using these cell lines to measure changes in protein levels after treatment with different compounds. Dr. Wendy Kuohung received her medical degree from the Yale University School of Medicine, completed her residency in Obstetrics and Gynecology at Boston Medical Center, and conducted fellowship training in Reproductive Endocrinology and Infertility at Brigham and Women's Hospital. She is currently the Division Director of Reproductive Endocrinology and Infertility at Boston Medical Center and an Associate Professor of Obstetrics and Gynecology at Boston University Chobanian & Avedisian School of Medicine Named for the infant son of preeclampsia survivor Lauren Pappas and her husband Clement, the Peter Joseph Pappas Research Grants program award grants totaling up to $200,000 each year. The ultimate goal of the program is to drive research that will eliminate the delivery of pre-term babies as an intervention for severe preeclampsia, HELLP syndrome, and related hypertensive disorders of pregnancy. "We lost our son Peter due to preeclampsia following a 29-week delivery in 2015," explained Lauren Pappas. "Since then, we have dedicated our lives to helping others avoid the same outcome by establishing the Peter Joseph Pappas Fund." "Thanks to generous contributions from family and friends, and our partnership with the Preeclampsia Foundation, we are making strides to reach our ultimate goal of eliminating pre-term births due to preeclampsia by 2050," added Clement Pappas. The Peter Joseph Pappas Research Grants program adds to the Preeclampsia Foundation's portfolio of research programs including the Vision Grant program for young investigators, PRIME for health services research, and EMPOWER, which helps build research capacity in low- and middle-income countries. Questions about Peter Joseph Pappas Research Grants program? Email PJPGrants@preeclampsia.org. About the Preeclampsia Foundation The Preeclampsia Foundation is a U.S.-based 501(c)(3) non-profit organization established in 2000 to improve the outcomes of hypertensive disorders of pregnancy by educating, supporting, and engaging the community, improving healthcare practices, and finding a cure. We envision a world where preeclampsia and related hypertensive disorders of pregnancy no longer threaten the lives of mothers and babies. For more information, visit . About the Peter Joseph Pappas Research Grant Program Clement and Lauren Pappas of Philadelphia, PA, lost their firstborn child, Peter Joseph, after HELLP syndrome necessitated his early delivery. Their son, born at 29 weeks' gestation, spent a week in the neonatal intensive care unit before dying from a central line infection. The Pappas family, along with friends and family, have established this special fund with the Preeclampsia Foundation to advance research, with the overarching goal of eliminating pre-term births due to preeclampsia by 2050. Contact: Laney Poye Director of Communications and Engagement 321.421.6957 353428@email4pr.com

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