The Lack of Neonatal Consequences in Pre-Eclampsia, Eclampsia and HELLP Syndrome: A Surprising Finding

Abstract

Background: Knowledge of the correlation between maternal conditions, especially during pregnancy and fetal outcomes is paramount to optimal care in pediatrics. One which has not been frequently studied in the literature is pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes and low platelets (HELLP). Methods: A retrospective review of all documented cases of pre-eclampsia, eclampsia and HELLP was done at a community Regional Neonatal Center. Over a five year period, 291 mothers were diagnosed with one of the three diseases and gave birth to 318 children. The children were stratified for gestational age and birth weight. Selected conditions were screened for in the medical record over the first year of life. Results: Of the 318 neonates, two were still births and one mother died from intracranial hemorrhage in the face of HELLP. Two hundred and twelve (66.67%) were born before 37 weeks, which is higher than the expected rate for these conditions. A total of 114 neonates were low birth weight (36%), while 75 were very low birth weight (23%). None of the conditions appeared significantly different for their suspected incidence when stratified for gestational age and birth weight. Conclusion: Eclampsia and HELLP are serious conditions in the pregnant patient, which significantly increase rates of preterm delivery, as well as correlates with low birth weights. As with all maternal conditions, thought must be given to the effect of these derangements on the developing fetus. Conditions such as necrotizing enterocolitis (NEC) caused by low flow sates and intestinal atresias, thought to occur with vascular incidents, were not seen at a higher rate in these patients once stratified for gestational age and birth weight.

Keywords

• Eclampsia
• Pre-eclampsia
• Neonatal surgery
• Premature surgery