Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria

Kinikanwo Green; Collins Amadi

doi:doi:10.11648/j.sjcm.20211004.17

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Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria

Kinikanwo Green, Collins Amadi

Published in Science Journal of Clinical Medicine (Volume 10, Issue 4)

Received: 25 October 2021 Accepted: 10 November 2021 Published: 23 November 2021

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Abstract

Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.

Published in	Science Journal of Clinical Medicine (Volume 10, Issue 4)
DOI	10.11648/j.sjcm.20211004.17
Page(s)	120-125
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

HELLP, HELLP Syndrome, Class 3 HELLP Syndrome

References

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[3]	Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth. 2009; 9: 8. doi: 10.1186/1471-2393-9-8.
[4]	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; 33 (4): 331-7. doi: 10.3109/01443615.2013.775231.
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[6]	Rimaitis K, Grauslyte L, Zavackiene A, Baliuliene V, Nadisauskiene R, Macas A. Diagnosis of HELLP syndrome: a 10-year survey in a perinatology centre. Int J Environ Res Public Health. 2019; 16 (1): 109.
[7]	Martin Jr JN, Owens MY, Keiser SD, Parrish MR, Tam Tam KB, Brewer JM, Cushman JL, May WL. Standardized Mississippi Protocol treatment of 190 patients with HELLP syndrome: slowing disease progression and preventing new major maternal morbidity. Hypertension in pregnancy. 2012; 31 (1): 79-90.
[8]	Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet gynecol. 1993; 169 (4): 1000-6.
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[13]	Asghamia M, Mirblouk F, Kazemi S, Pourmarzi D, Keivani MM, Heirati SFD. Maternal serum uric acid and maternal and neonatal complications in preeclamptic women: A cross-sectional study. Int J Reprod Biomed. 2017; 15 (9): 583 – 588.
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APA Style

Kinikanwo Green, Collins Amadi. (2021). Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Science Journal of Clinical Medicine, 10(4), 120-125. https://doi.org/10.11648/j.sjcm.20211004.17

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ACS Style

Kinikanwo Green; Collins Amadi. Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Sci. J. Clin. Med. 2021, 10(4), 120-125. doi: 10.11648/j.sjcm.20211004.17

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AMA Style

Kinikanwo Green, Collins Amadi. Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Sci J Clin Med. 2021;10(4):120-125. doi: 10.11648/j.sjcm.20211004.17

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@article{10.11648/j.sjcm.20211004.17,
  author = {Kinikanwo Green and Collins Amadi},
  title = {Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria},
  journal = {Science Journal of Clinical Medicine},
  volume = {10},
  number = {4},
  pages = {120-125},
  doi = {10.11648/j.sjcm.20211004.17},
  url = {https://doi.org/10.11648/j.sjcm.20211004.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211004.17},
  abstract = {Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.},
 year = {2021}
}

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TY  - JOUR
T1  - Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria
AU  - Kinikanwo Green
AU  - Collins Amadi
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.sjcm.20211004.17
DO  - 10.11648/j.sjcm.20211004.17
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 120
EP  - 125
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20211004.17
AB  - Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.
VL  - 10
IS  - 4
ER  -

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Author Information

Kinikanwo Green

Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
Collins Amadi

Department of Chemical Pathology, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

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APA Style

Kinikanwo Green, Collins Amadi. (2021). Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Science Journal of Clinical Medicine, 10(4), 120-125. https://doi.org/10.11648/j.sjcm.20211004.17

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ACS Style

Kinikanwo Green; Collins Amadi. Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Sci. J. Clin. Med. 2021, 10(4), 120-125. doi: 10.11648/j.sjcm.20211004.17

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AMA Style

Kinikanwo Green, Collins Amadi. Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria. Sci J Clin Med. 2021;10(4):120-125. doi: 10.11648/j.sjcm.20211004.17

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@article{10.11648/j.sjcm.20211004.17,
  author = {Kinikanwo Green and Collins Amadi},
  title = {Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria},
  journal = {Science Journal of Clinical Medicine},
  volume = {10},
  number = {4},
  pages = {120-125},
  doi = {10.11648/j.sjcm.20211004.17},
  url = {https://doi.org/10.11648/j.sjcm.20211004.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211004.17},
  abstract = {Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.},
 year = {2021}
}

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TY  - JOUR
T1  - Progression of Class 3 HELLP Syndrome: Biochemical Indicators Among Women in Port Harcourt, South-south Nigeria
AU  - Kinikanwo Green
AU  - Collins Amadi
Y1  - 2021/11/23
PY  - 2021
N1  - https://doi.org/10.11648/j.sjcm.20211004.17
DO  - 10.11648/j.sjcm.20211004.17
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 120
EP  - 125
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20211004.17
AB  - Background: Class 3 HELLP syndrome (c3HELLPs) is a mild transition stage of HELLP syndrome (HELLPs) with potential for rapid progression to more severe variants. Biochemical indicators of its progression are poorly understood. Hence, the current study evaluated the likely biochemical indicators of this progression among women in Port Harcourt, Nigeria. Methods: The current study was designed as a retrospective cross-sectional one and was conducted among women diagnosed with c3HELLPs in the University of Port Harcourt Teaching Hospital (UPTH) from 2011-2020. Relevant data from all eligible cases were abstracted from case notes, nurses’ charts, laboratory, and medical records using well-structured research pro forma and analyzed using the Statistical Package for Social Sciences version 25. Results: During the study period, 84 cases of c3HELLPs presented; 58 progressed while 26 did not progress while on management. The progressed cases had higher mean and abnormal levels of plasma uric acid (UA), creatinine, but low and abnormal levels of plasma albumin compared to the non-progressed c3HELLPs cases (p<0.05). The abnormally high UA, creatinine, and abnormally low albumin levels were associated with increased risk of c3HELLPs progression on crude/adjusted logistic regression (LR) and ROC analysis. However, the UA had a superior LR (crude=OR: 4.097; 95%CI: 2.917-5.753; p<0.001; adjusted=OR: 4.723; 95%CI: 3.199-5.763; p<0.001) and ROC (AUC: 0.978; 95%CI: 0.887-1.000; <0.001) predictive potentials. Conclusion: The study showed that rising plasma UA, creatinine levels but falling plasma albumin levels may indicate an increased risk of c3HELLPs progression. This finding should be considered along with clinical features and other HELLP-defined laboratory markers during the management of c3HELLPs. However, we recommend further studies to evaluate conclusions from this study.
VL  - 10
IS  - 4
ER  -

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