Long-term outcomes 5 years after HELLP

[caryn]

Fifty-three patients had subsequent pregnancies with 24% complicated by HELLP and 28% by preeclampsia. During follow-up, 33% of the patients had new onset hypertension develop, 32% had depression develop, 26% had anxiety develop, and 2.4% required dialysis. There was no significant difference in long-term outcome between comparison groups.

http://www.ncbi.nlm.nih.gov/pubmed/19716544

So it didn't matter to outcomes how early you developed HELLP in your first pregnancy. In a subsequent pregnancy, you had almost a 1 in 4 chance of developing HELLP and a little more than a 1 in 4 chance of developing preeclampsia. You have about a 1 in 3 chance of developing chronic hypertension or depression within the first five years postpartum. You have about a 1 in 4 chance of developing diagnosable anxiety. And you have a 1 in 50 chance of needing dialysis within 5 years.

Geez, those numbers are *not* cheery.

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[jend01]

No they are not. That is something else to think about now before trying again. :(

[mother bear]

Gosh. Whatever happened to that 5% recurrence rate for HELLP? Now it's 25%? (I say as someone who was discharged from the hospital at a platelet level of 145 without a HELLP diagnosis and produced maple-syrup urine a week later...) And the rest of those numbers are just... I just don't have the words for them.

[audrey s.]

Well, at fourteen years out, my kidney numbers are always borderline high (and renal insufficiency runs in my family), and I've always wondered. OTOH, I also have years of ibuprofen use for endometriosis, and that too can hit the kidneys pretty hard. I guess it's just a good thing, in my case, that being 40 when my daughter was born (and having had two ectopics before), pretty much ruled out our ever trying again even if things HAD gone normally (which of course they didn't).

Just more ammunition for the PCPs of those of us who are dealing with issues years later!

[rebeccac]

Ah yes, when I had the crazy idea to maybe try again, I had a pre-conception consult and the Dr. gave me the 1 in 4 chance of developing HELLP again. That made it a no go for me....

[tree]

That just stinks... Most of us liked the 5% number much better, even if it was really fuzzy.
Is there anything more encouraging in the full paper? I don't have full PubMed access through work, and it will take me a couple of days to get it.

[missgamecock]

I was given the 25% of pe chance with Sara. Then it turned up to a 100% chance with Cate and any other babies.....

[caryn]

This isn't risk of occurrence with a history of PE, just with a history of HELLP.

[audrey s.]

Yeah, well, I had full-blown HELLP, and my problems stem much more from that. I only had labile hypertension, not consistent; what I had was the hyper-reflexia which also caused the arteries in my legs to go into spasm...still a problem now 14 years later, unfortunately.

[amandaoasis]

Caryn,

Does the study differentiate between HELLP and Pre-e pregnancies? What I mean is, did HELLP survivors have an almost 50% chance of developing one or the other or was HELLP considered a Pre-e pregnancy and so overall recurrence was around 25%?

I don't know if that made sense...sorry.