Evaluation of Hellp Syndrome Management

Author(s): Zelmat SA, Bouabida D, Bellalaoui I, Zaoui C, Boucherite E, Mazour F

Inroduction: HS (hemolysis, elevated liver enzymes, low platelet count) is an obstetric emergency with significant maternofetal morbidity and mortality. Its diagnosis is difficult, sometimes in a hyperacute manner in the form of a multi-visceral failure syndrome. The prognosis of this pathology depends on the quality of care. Fifty present of HS-related deaths are due to delayed diagnosis and management. According to the formalized recommendations of common experts in 2009 SFAR / ICNGOF / SFMP / SFNN the improvement of HS care mainly concerns the information and training of the nursing staff and the patient and the organization of networked care. For this reason, a research was conducted in the ORAN EHUO gynéco-obstetrics department for patients with HS whose objective is to evaluate the effect of an intervention aimed at improving the human factor. Complications, maternal mortality, time to care, length of stay and patient satisfaction, and describe the factors associated with death in the HS.

Material: The study was conducted at the gynecological obstetrics department in two phases. A retrospective study during the period from January 2014 to the end of 2015 was performed on patients hospitalized for HS including clinical, biological, socio-epidemiological characteristics, complications, delays and duration of hospitalization , maternal deaths and perinatal, and patient satisfaction; then an intervention on the human factor was implemented gradually and continuously from January 2016 to the end of 2017. The evaluation of the intervention was done through the before-after study method.

Result: The analysis of the data concluded that there were 165 cases of HS, a frequency which increased significantly between the two phases from 0.35% in the first phase to 1.5% in the second phase. Maternal deaths had significantly decreased from 15.7% to 3.14% between the two phases (P = 0.0