Eficácia da haptoglobina como marcador de hemólise no diagnóstico da síndrome HELLP

• Autor(a) principal: Higa, Thais Tiemi [UNESP]
• Data de Publicação: 2013
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/124248; http://www.athena.biblioteca.unesp.br/exlibris/bd/capelo/2015-06-15/000830620.pdf
• topic: Pre-eclampsia; Hemolise e hemolisinas; Síndrome HELLP; Mulheres grávidas; Gravidez - Complicações; Pregnancy - Complications

Introduction: The HELLP syndrome is a severe complication of pregnant women with preeclampsia (PE), characterized by association of hemolysis, changes in liver enzymes and thrombocytopenia. Hemolysis, defined by the presence of microangiopathic hemolytic anemia, is one of the characteristics in this syndrome. However, as hemolysis occurs in a short time there is some difficulty in its laboratory diagnosis. Therefore, the search for a more sensitive and specific method for hemolysis determination may help in the early diagnosis of the HELLP syndrome. Objectives: a) To determine the plasma concentration of haptoglobin in normotensive pregnant women and in pregnant women with PE, classified into mild PE, severe PE and HELLP/partial HELLP syndrome; b) To compare the efficacy of haptoglobin plasma concentration and serum total bilirubin as criteria for hemolysis diagnosis in HELLP/partial HELLP syndrome. Methods: We conducted a cross-sectional analytical and comparative study involving 66 pregnant women diagnosed with PE, being 25 cases with mild PE, 28 with severe PE, and 13 with HELLP/partial HELLP syndrome. Twenty-one normotensive pregnant women were included for comparison of haptoglobin plasma concentration between the groups and to determine the normal values for pregnant women. The variables studied were: maternal age, gestational age, systolic and diastolic blood pressure, proteinuria, hematocrit and hemoglobin values, platelet count, serum total bilirubin, lactate dehydrogenase (LDH), glutamic oxaloacetic transaminase (AST) and glutamic-pyruvic transaminase (ALT), urea, creatinine and uric acid, and also plasma concentrations of haptoglobin. The results were analyzed by nonparametric tests, with a significance level of 5%. Results: The values of urea, uric acid, AST, ALT and LDH were significantly higher, while the number of platelets was lower in pregnant women with HELLP/partial HELLP syndrome compared to pregnant women with mild PE and ...