Download Free Medical Hellp Syndrome PowerPoint Presentation

Hellp Syndrome PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Weinstein regarded signs and symptoms to constitute an entity separate from severe preeclampsia and in 1982 named the condition HELLP

Tags : Syndrome,symptoms,HELLP Syndrome,epigastric pain

Published on : Feb 13, 2023 | Views : 2772 | Downloads : 10

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

HELLP Syndrome
Slide 2-

Objectives Intro of disease Symptoms Sign Diagnosis Classification Differential diagnosis Management Summary
Slide 3-

HELLP Syndrome Weinstein regarded signs and symptoms to constitute an entity separate from severe preeclampsia and in 1982 named the condition HELLP H = Haemolysis EL = Elevated Liver enzymes LP = Low Platelets currently regarded as a variant of severe preeclampsia or a complication . HELLP syndrome usually develops within the first 48 hours in women who have had proteinuria and hypertension prior to delivery
Slide 4-

Cont.... The HELLP syndrome occurs in about 0.5 to 0.9% of all pregnancies and in 10 to 20% of cases with severe preeclampsia 70% of the cases develops before delivery with a peak frequency between the 27th and 37th gestational weeks 10% occur before the 27th week 20% beyond the 37th gestational week hypertension and proteinuria absent in 10–20% of the cases
Slide 5-

Causes of maternal death in developed countries WHO data on maternal mortality
Slide 6-

Symptoms right upper abdominal quadrant epigastric pain nausea and vomiting 30–60% of women have headache 20% visual symptoms partial HELLP syndrome fewer symptoms less complications
Slide 7-

Reported frequency of signs and symptoms of HELLP syndrome
Slide 8-

ppt slide no 8 content not found
Slide 9-

H(hemolysis) high LDH concentration unconjugated bilirubin low or undetectable haptoglobin concentration is a more specific indicator. Low haptoglobin concentration (< 1 g/L – < 0.4 g/L) Haemolysis, one of the major characteristics of the disorder, is due to a microangiopathic haemolytic anaemia
Slide 10-

Elevated Liver enzymes(EL) Elevation of liver enzymes may reflect the haemolytic process as well as liver involvement. Haemolysis contributes to the elevated levels of LDH enhanced asparate aminotransferase (AST) and alanine aminotransferase (ALAT) levels are mostly due to liver injury
Slide 11-

Low platelet(LP) Thrombocytopenia < 150·109/L) caused by gestational thrombocytopenia (GT) (59%) immune thrombocytopenic purpura (ITP) (11%) preeclampsia (10%) HELLP syndrome (12%). PLTs < 100·109/L are relatively rare in preeclampsia and gestational thrombocytopenia, frequent in ITP and obligatory in the HELLP syndrome (according to the Sibai definition)
Slide 12-

Diagnosis Many different criteria Biochemical markers Clinical Preeclampsia ELLP
Slide 13-

ppt slide no 13 content not found
Slide 14-

Tennessee Classification System Platelets ≤ 100·109/L AST ≥ 70 IU/L LDH ≥ 600 IU/L Sibai has proposed strict criteria for "true" or "complete" HELLP syndrome Intravascular haemolysis is diagnosed by abnormal peripheral blood smear, increased serum bilirubin (≥ 20.5 μmol/L or ≥ 1.2 mg/100 mL) and elevated LDH levels (> 600 units/L (U/L)
Slide 15-

Mississippi classificationClass 1 Platelets ≤ 50·109/L AST ≥ 70 IU/LAST LDH ≥ 600 IU/L Platelets ≤ 100·109/L≥ 50·109/L AST or ALT ≥ 70 IU/L LDH ≥ 600 IU/L Class 2 Class 3 Platelets ≤ 150·109/L≥ 100·109/L AST or ALT ≥ 40 IU/L LDH ≥ 600 IU/L
Slide 16-

Differential diagnosis viral hepatitis cholangitis and other acute disease ITP acute fatty liver of pregnancy (AFLP) haemolytic uremic syndrome (HUS) thrombotic thrombocytopenic purpura (TTP) systemic lupus erythematosus (SLE)
Slide 17-

Complications reported
Slide 18-

Management > 34 weeks' gestation or later Nonreassuring tests of fetal status Presence of severe maternal disease: multiorgan dysfunction, DIC, liver infarction or hemorrhage, renal failure, or abruptio placenta Immediate delivery 27 to 34 weeks of gestation Delivery within 48 hours evaluation stabilization steroid treatment for fetal lung maturity before 24 weeks' gestation, termination of pregnancy should be strongly considered
Slide 19-

HELLP syndrome
Slide 20-

Method of Delivery Vaginal Cesarean section
Slide 21-

Intensive Care - The use of Dexamethasone  ANTEPARTUM: (0,15mg/kg)10mg IV bid - when Platelets <100.000/mm 3 - if Platelets 100.000-50.000/mm 3 AND Eclampsia, Severe Hypertension, Epigastric Pain  POSTPARTUM: 10mg IV bid for 2 dosis, then 5mg bid for 2 additional doses: - when steroids were used in antepartum - suspend when there is clinical and laboratory improvement (platelets >100.000mm 3, decreased LDH, diuresis >100 ml/h)
Slide 22-

Steroid use no clear evidence of any effect of corticosteroids on substantive clinical outcomes. insufficient evidence for the routine use The use of corticosteroids only to increase rate of recovery in platelet count if considered clinically worthwhile.
Slide 23-

Anesthesia Choice According to ACOG regional anesthesia is preferred for women with preeclapmsia and eclampsia General anesthesia carries more risk than regional Platelet counts >100,000/ul are acceptable to most anesthesiologists Platelet counts in 50,000-100,000 range are potential candidates according to ACOG Risk of spinal or epidural hematoma Paralysis
Slide 24-

Conclusion HELLP syndrome is unique to pregnancy HELLP syndrome develops in approximately 1 of 1000 pregnancies overall and 10 to 20 percent of pregnancies with severe preeclampsia/eclampsia Delivery and supportive management is cure Multidisciplinary approach Tertiary center outcome for mothers with HELLP syndrome is generally good, but serious complications can occur Recommendations are against giving dexamethasone for treatment
Slide 25-

Case
Slide 26-

ppt slide no 26 content not found