Maternal and Fetal Outcomes of Patients with HELLP Syndrome

Submission: 05 December 2025 | Acceptance: 29 December 2025 | Publication: 17 January 2026

Shazia Shah¹, Rehana Kamal², Ifrah Rameen³, Aisha Siddiqa⁴,Dr. Hadiqa⁵,Dr.Shazia⁶

Postgraduate Student, Department of Obstetrics & Gynecology, Sandeman Provincial Hospital, Quetta
Associated professor, Department of Obstetrics & Gynecology, Sandeman Provincial Hospital, Quetta
Postgraduate Student, Department of Obstetrics & Gynecology, Sandeman Provincial Hospital, Quetta
Professor, Ex-Head of Obstetrics & Gynecology Department, Bolan Medical College, Quetta
WMO sarhad government hospital for psychiatric diseases
Category D hospital Munda, Dir lower, KPK

ABSTRACT:

Objective: To determine the maternal and fetal outcomes of patients with HELLP syndrome.

Methods: This cross-sectional study was conducted at the Department of Obstetrics & Gynecology, Sandeman Provincial Hospital, Quetta, from June 1^stto November 30^th2025, using non-probability consecutive sampling. Pregnant women aged 18 to 35 years, above 24 weeks of gestation, diagnosed with HELLP syndrome were included regardless of gravida status. Those with hepatic disease, hemolytic anemia, platelet disorders, chronic hypertension, or chronic renal disease were excluded to avoid bias. After ethical approval, eligible inpatients were enrolled. Data collection involved clinical evaluation and lab tests, including blood counts, coagulation profiles, liver and renal function tests. Disseminated intravascular coagulation was diagnosed by platelet counts and coagulation parameters. Ultrasound and ophthalmoscopy (if severe) were performed. Magnesium sulfate was used for seizure control; blood pressure was managed with labetalol or nifedipine. Blood products and antenatal steroids were administered as needed. Fetal monitoring included biophysical profiles and Doppler. Pregnancy management decisions were based on maternal and fetal status. Patients were cared for in HDU or ICU if necessary. Data were recorded on a pre-designed proforma, with strict exclusion to reduce confounding.

Results: Out of 117 pregnant women diagnosed with HELLP syndrome, 38.5% resided in urban areas and 61.5% in rural areas, indicating higher prevalence in rural settings. The mean age was 23.9 ± 3.1 years, weight 52.6 ± 7.3 kg, height 155.5 ± 7.4 cm, and BMI 21.9 ± 3.7 kg/m². Mean gestational age at diagnosis was 32.6 ± 2.9 weeks. Primigravida women accounted for 36.8%, multigravida 63.2%. Maternal outcomes included pre-eclampsia (41.9%), postpartum hemorrhage (26.5%), placental abruption (22.2%), and maternal death (9.4%). Fetal outcomes showed preterm birth (40.2%), low birth weight (25.6%), IUGR (23.9%), and respiratory distress syndrome (10.3%). Educationally, 20.5% had primary, 25.6% secondary, 32.5% intermediate, and 21.4% graduate levels. Most women (66.7%) belonged to the lower socioeconomic class. Significant associations existed between place of residence and maternal (p=0.040) and fetal outcomes (p=0.038), with rural women facing more severe complications. No significant associations were found with gravida status or socioeconomic status. Educational status was significantly linked to fetal outcomes (p=0.016), with lower education correlating with worse fetal health. Gestational age categories showed no significant effect on outcomes, despite clinical trends. These findings highlight rural residence and education as key factors influencing HELLP syndrome outcomes.

Conclusion:It shows that the HELLP syndrome is associated with both a high maternal and fetal morbidity, being worse for rural women and those with lower levels of education. Greater contribution of social variables. Since gravidity, socioeconomic status, gestational age, and maternal age were less significant compared to the role of some social factors. Improved maternal health literacy and prenatal care, especially in impoverished areas, may explain the reduced morbidity from HELLP syndrome.

Keywords:HELLP Syndrome, Maternal Outcome,Fetal Outcome,Pregnancy Complications.