The impact of biochemical marker levels in pregnant patients diagnosed with HELLP syndrome on predicting the progression and recovery timelines

Objectives: This study investigates the role of biochemical markers in predicting the clinical course of pregnant women with Hemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome, aiming to correlate marker levels with disease progression and recovery timelines for improved prognostic assessment and therapeutic strategies.
Methods: A retrospective analysis was conducted on 50 pregnant patients (aged 18-45) diagnosed with HELLP syndrome between October 2022 and November 2023. Data on demographics, vital signs, clinical symptoms, and laboratory markers (platelets, liver enzymes, lactate dehydrogenase [LDH], and bilirubin) were examined. Outcomes measured included complications, intensive care unit needs, and recovery time.
Results: The mean age was 30.74±5.27 years and body mass index of 29.76±5.88 kg/m2. The gestational age was 31.97±4.45 weeks. Significant cut-off values were identified for urea at 27.50 (sensitivity: 100%, specificity: 73%, R2= 0.553, P<0.001) and creatinine at 0.85 (sensitivity: 100%, specificity: 91%, (P<0.001). LDH, bilirubin, and platelets also showed predictive value for clinical outcomes (P-values ranging from 0.005 to <0.05). Neutrophil-to-Lymphocyte Ratio and urea correlated with longer postpartum stays and complications, while higher mean platelet volume was linked to shorter stays (NLR: β = 0.303, P=0.009; BUN: β = 0.553, P< 0.001).
Conclusions: The study highlights the importance of renal and hematological markers (urea, creatinine, LDH, bilirubin, platelets) in predicting HELLP outcomes. Renal markers showed high sensitivity, while hematological markers correlated with hospital stay duration, supporting their integration into clinical protocols to optimize treatment and patient management.