Preeclampsia and HELLP Syndrome

Pregnancy induced hypertension occurs in about 6 to 8 % of all pregnancies and is responsible for 25 % of newborns’ deaths until the 7th day after delivery in Europe and Countries of the Western world. It is the second most common cause of maternal lethality. Preeclampsia and HELLP Syndrome - formally called gestosis - are the most dramatic forms of hypertensive disorders affecting about 2 % of pregnant women. The underlying mechanisms that initiate preeclampsia or HELLP-Syndrome in a pregnant woman are still not verified but are believed to be triggered by pathologic conditions in the placental area. The most common reason for their occurrence manifests early during pregnancy in the setting of the developing placenta.

Women with a history of preeclampsia or HELLP Syndrome are at risk for miscarriage recurrence in subsequent pregnancies, whereas the risk of recurrence is particularly higher in women with history of early onset preeclampsia /HELLP Syndrome before 28th week of gestation:

≤ 28. SSW ⇒ 38.6 %
29. – 32. SSW ⇒ 29.1 %
33. – 36. SSW ⇒ 21.9 %
≥ 37. SSW ⇒ 2.9 %

Risk assessment of recurrence in women with a history of Preeclampsia/HELLP-Syndrome according to German Society of Gynecology and Obstetrics (DGGG))

Previous  preeclampsia: risk of recurrence: 11.5 – 27 %
Preeclampsia in 2 pregnancies: risk of recurrence: ≈ 32 %
Pregnancy induced hypertension (PIH): risk of preeclampsia: 2 – 7 %
Previous HELLP-Syndrome: risk of preeclampsia HELLP-S: 12.8 %
Previous eclampsia: risk of eclapmsia: 2 – 16 % // risk of preeclampsia: 22 – 35 %

Who, when and what should be clarified?

Risk assessment of recurrence should be considered in women with previous HELLP-Syndrome or severe preeclampsia. These include events that occurred before the 32nd week of gestation or that were associated with severe growth restriction of the child.

Investigations include exclusion of:

  • autoimmune disease
  • acquired or genetic coagulation disorders
  • impaired microzirkulatory bloodflow properties
  • immunologic disorders

Please provide all medical reports, histologic results and laboratory findings when appointing our unit. Please fill out the form sheet on our home page.

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