Practitioners of obstetrics, maternal-fetal medicine and consultants in other branches of medicine who help provide excellent care to pregnant patients with hypertensive complications of pregnancy will welcome this compendium about HELLP Syndrome. Drawing upon the expertise of 37 contributors from 15 institutions and four countries, this book summarizes the state of the science and practice for patients with HELLP syndrome. On a global basis, what we call HELLP syndrome accounts for hundreds to thousands of maternal deaths and is responsible for many more thousands of patients that suffer "near miss" mortality, which we more properly term "severe maternal morbidity". Our understanding of this pregnancy scourge – the basic science or bench aspects – is still relatively inadequate to fully comprehend the pathogenesis and the pathophysiology of this condition as it relates to its close relative, the syndromic disorder of preeclampsia. Although a corticosteroid-based management scheme has shown great promise in practice and has a strong physiologic basis, there remains a need for a high quality, large-scale (1000+ patients) constructed, prospective placebo-controlled clinical trial involving a heterogeneous patient population to fully and objectively evaluate this approach to practice. The need and the urgency are great given the risk of HELLP to mothers and babies. What we do know is detailed extensively in the pages within. Contained within the compendium is a current summation of our knowledge about the following aspects of HELLP syndrome:How do HELLP and preeclampsia share similarities or demonstrate differences The latest on clinical and laboratory diagnoses of HELLP syndrome, including cutting edge research Classes and categories of HELLP are clarified for full implementation into practice Core concepts and components of recommended management A critical look at the current controversy over corticosteroids as a core component of care for patients with HELLP syndrome and the reasons why the jury is still out How HELLP impacts maternal morbidity and mortality In-depth looks at each of the organ systems impacted by HELLP including the mother’s brain, heart/lungs, the liver and the kidney Help with distinguishing HELLP from imitators Review of the concepts of rescue with therapeutic plasma exchange when other disorders complicate and confuse patient presentation and care Guidance with anesthesia issues of HELLP patient management and potential pitfalls Perinatal and neonatal aspects of HELLPRisk factors, epidemiology, and recurrence issues The infrequently explored areas of HELLP impact on immediate and remote maternal physical and emotional health Welcome to this extensive and detailed compendium of helpful HELLP syndrome information for practitioners, researchers, patients and all those interested in pregnancy and conditions which threaten its successful outcome.
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