Postpartum heparin therapy for patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) is associated with significant hemorrhagic complications

Laura Detti, Federico Mecacci, Anna Piccioli, Sante Ferrarello, Lucia Carignani, Giorgio Mello, James E. Ferguson, Gianfranco Scarselli

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To compare the outcome of two groups of 16 patients with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome treated with heparin therapy or treated conservatively in the postpartum period. Study design: This is a retrospective cohort study comparing 16 consecutive patients with HELLP syndrome admitted to the ICU at the University of Florence (Italy) after delivery and treated with heparin, to 16 patients with the same disease admitted to the University of Virginia (UVA, USA) and treated with supportive therapy. Results: Nine patients in the Florence group developed disseminated intravascular coagulation (DIC). Six of them developed postpartum hemorrhage that was medically and surgically controlled. Five hysterectomies were performed and seven other laparotomies were necessary in four patients to control further bleeding complications. In the UVA group, one patient developed DIC and another one a retroperitoneal hematoma that resolved with no need for surgical intervention. Conclusions: Heparin therapy for postpartum patients with HELLP syndrome was associated with bleeding complications. We speculate that the heparin therapy was the cause for the bleeding complications occurred in the Florence group of patients.

Original languageEnglish (US)
Pages (from-to)236-240
Number of pages5
JournalJournal of Perinatology
Volume25
Issue number4
DOIs
StatePublished - Apr 1 2005

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Hemolysis
Postpartum Period
Heparin
Blood Platelets
Liver
Enzymes
Disseminated Intravascular Coagulation
Therapeutics
Hemorrhage
Postpartum Hemorrhage
Hysterectomy
Hematoma
Laparotomy
Italy
Cohort Studies
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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Postpartum heparin therapy for patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) is associated with significant hemorrhagic complications. / Detti, Laura; Mecacci, Federico; Piccioli, Anna; Ferrarello, Sante; Carignani, Lucia; Mello, Giorgio; Ferguson, James E.; Scarselli, Gianfranco.

In: Journal of Perinatology, Vol. 25, No. 4, 01.04.2005, p. 236-240.

Research output: Contribution to journalArticle

Detti, Laura ; Mecacci, Federico ; Piccioli, Anna ; Ferrarello, Sante ; Carignani, Lucia ; Mello, Giorgio ; Ferguson, James E. ; Scarselli, Gianfranco. / Postpartum heparin therapy for patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) is associated with significant hemorrhagic complications. In: Journal of Perinatology. 2005 ; Vol. 25, No. 4. pp. 236-240.
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AU - Carignani, Lucia

AU - Mello, Giorgio

AU - Ferguson, James E.

AU - Scarselli, Gianfranco

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N2 - Objective: To compare the outcome of two groups of 16 patients with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome treated with heparin therapy or treated conservatively in the postpartum period. Study design: This is a retrospective cohort study comparing 16 consecutive patients with HELLP syndrome admitted to the ICU at the University of Florence (Italy) after delivery and treated with heparin, to 16 patients with the same disease admitted to the University of Virginia (UVA, USA) and treated with supportive therapy. Results: Nine patients in the Florence group developed disseminated intravascular coagulation (DIC). Six of them developed postpartum hemorrhage that was medically and surgically controlled. Five hysterectomies were performed and seven other laparotomies were necessary in four patients to control further bleeding complications. In the UVA group, one patient developed DIC and another one a retroperitoneal hematoma that resolved with no need for surgical intervention. Conclusions: Heparin therapy for postpartum patients with HELLP syndrome was associated with bleeding complications. We speculate that the heparin therapy was the cause for the bleeding complications occurred in the Florence group of patients.

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