IJCI International Journal of Clinical Innovation IJCI International Journal of Clinical Innovation IJCI-2026-0019 Clinical Characteristics and Maternal and Fetal-Neonatal Complications Among Patients With HELLP Syndrome: A Retrospective Single-Center Study Maternal and Fetal-Neonatal Complications in HELLP Syndrome José Ángel Colmenarez Cordero MD Marisjua Francyl Figueroa Ledezma MD María Alejandra Gutiérrez Pérez MD Medicine, Universidad Nacional Experimental Romulo Gallegos, San Juan de los Morros, Venezuela Corresponding author: José Ángel Colmenarez Cordero. Correspondence via editorial@ijcinnovation.org. 27 09 2026 1 1 26 09 2026 27 09 2026 © The Author(s). Authors retain copyright. This article is distributed under the Creative Commons Attribution 4.0 International (CC BY 4.0), which permits sharing and adaptation, including commercial reuse, provided appropriate credit is given, a link to the license is supplied, and changes are indicated. Third-party material is covered only when the article or credit line does not state otherwise.

Background: HELLP syndrome—hemolysis, elevated liver enzymes, and low platelet count—is a severe pregnancy complication associated with substantial maternal and perinatal morbidity. Published data from Venezuela remain limited, and historical hospital cohorts can provide useful descriptive information when their methodological limitations are explicitly recognized.

Objective: To describe demographic and obstetric characteristics, clinical and laboratory features, and maternal and fetal-neonatal complications among patients with a chart-documented diagnosis of HELLP syndrome at a high-risk maternity service in Venezuela.

Methods: We performed a retrospective, descriptive, single-center medical-record review of 106 patients treated at the Maternidad de Alto Riesgo Hugo Chávez, Ciudad Hospitalaria Dr. Enrique Tejera, Valencia, Venezuela, from May 2019 through May 2020. Eligible records had a chart-documented diagnosis of HELLP syndrome and available laboratory studies. Analyses were descriptive, and exact binomial 95% confidence intervals were calculated post hoc for key complication and mortality proportions.

Results: Among 106 patients, 74 (69.8%) were recorded in the preterm gestational-age category. Headache was documented in 76 (71.7%), nausea in 54 (50.9%), and epigastric pain in 45 (42.5%). Hemolysis was recorded in 74 (69.8%), elevated liver enzymes in 105 (99.1%), and thrombocytopenia in 79 (74.5%). At least one maternal complication occurred in 53 patients (50.0%; 95% CI, 40.1%–59.9%), while at least one fetal-neonatal complication occurred in 83 pregnancies (78.3%; 95% CI, 69.2%–85.7%). No maternal deaths were reported, and five fetal deaths were recorded.

Conclusion: This historical single-center series demonstrates a substantial burden of maternal and fetal-neonatal complications among patients with a chart-documented HELLP diagnosis. Because the study lacked a comparator group, uniform patient-level diagnostic adjudication, and patient-level data for reanalysis, the findings should be interpreted as descriptive regional evidence rather than as estimates of causal associations or independent risk factors.

 HELLP syndrome preeclampsia pregnancy complications maternal morbidity prematurity Venezuela Funding No external funding. Conflicts of interest The authors declare no conflicts of interest. Author contributions Individual author contributions were not documented in the source academic thesis; specific CRediT roles could therefore not be reliably assigned. Data availability Available from the corresponding author upon reasonable request. Ethics approval Approved Consent for publication Not Applicable References 1. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol. 1982;142(2):159-167. doi:10.1016/S0002-9378(16)32330-4. 2. American College of Obstetricians and Gynecologists. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260. doi:10.1097/AOG.0000000000003891. 3. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103(5 Pt 1):981-991. doi:10.1097/01.AOG.0000126245.35811.2a. 4. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A review. BMC Pregnancy Childbirth. 2009;9:8. doi:10.1186/1471-2393-9-8. 5. Magee LA, Brown MA, Hall DR, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022;27:148-169. doi:10.1016/j.preghy.2021.09.008. 6. Soto F, Rivera L, Estévez M, Ayala V, Cabrera C. Síndrome HELLP: morbilidad-mortalidad materna y perinatal. Rev Obstet Ginecol Venez. 2014;74(4):244-251. 7. Labarca L, Urdaneta JR, González ME, et al. Prevalencia del síndrome de HELLP en gestantes críticas: Maternidad “Dr. Armando Castillo Plaza”, Maracaibo, Venezuela. Rev Chil Obstet Ginecol. 2016;81(3):194-201. doi:10.4067/S0717-75262016000300005. 8. Vigil-De Gracia P, Rojas-Suarez J, Ramos E, et al. Incidence of eclampsia with HELLP syndrome and associated mortality in Latin America. Int J Gynaecol Obstet. 2015;129(3):219-222. doi:10.1016/j.ijgo.2014.11.024. 9. Liu Q, Ling GJ, Zhang SQ, Zhai WQ, Chen YJ. Effect of HELLP syndrome on acute kidney injury in pregnancy and pregnancy outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):657. doi:10.1186/s12884-020-03346-4. 10. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169(4):1000-1006. doi:10.1016/0002-9378(93)90043-I. 11. Barton JR, Sibai BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clin Perinatol. 2004;31(4):807-833, vii. doi:10.1016/j.clp.2004.06.008. 12. Giannubilo SR, Marzioni D, Tossetta G, Ciavattini A. HELLP Syndrome and Differential Diagnosis with Other Thrombotic Microangiopathies in Pregnancy. Diagnostics (Basel). 2024;14(4):352. doi:10.3390/diagnostics14040352. 13. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-1457. doi:10.1016/S0140-6736(07)61602-X.