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The clinic and intensive therapy of the HELLP syndrome and its complications


Author: Coşpormac Viorica
Degree:doctor of medicine
Speciality: 14.00.37 - Anaesthesiology and Reanimathology
Year:2013
Scientific adviser: Victor Cojocaru
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Olga Cerneţchi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 19 December, 2012
Approved by NCAA on the 14 June, 2013

Abstract

Adobe PDF document0.38 Mb / in romanian

Keywords

HELLP syndrome, preeclampsia, polyorganic insufficiency, haemolysis, thrombocytopenia, hypertransaminasemia, disseminated microangiopathy

Summary

The work includes 123 edited pages and consists of introduction, 6 chapters, conclusions, practical recommendations, bibliography comprising 179 references, 59 tables, 15 figures, 3 algorithms, 3 annexes. The obtained result were published in 8 scientific works.

Field of study: Medical sciences (anaesthesiology and reanimatology, obstetrics and gynaecology).

Aim of study: Evaluation of risk factors and clinic characteristics of HELLP syndrome, creation of precocious diagnostic algorithm and intensive treatment of HELLP syndrome complications in various perinatal periods.

Objectives of study: The estimation of risk factors and analysis of the clinic evolution of HELLP syndrome and its complications on patients based on perinatal period. Assessment of acid-alcaline and water-electrolyte imbalances, haemostasis for pacients with HELLP syndrome with different severity levels and in vario us perinatal periods. Building of the precocious diagnostic and intensive treatment algorithm for HELLP syndrome.

Scientific novelty and originality: Risk factors in the development of the syndrome and its complications have been determined; the clinic evolution of HELLP syndrome and the correlation between water-electrolyte, acid-alcaline and gaseous imbalances with the severity degree and perinatal period of HELLP syndrome have been established. Detrimental consequences of disseminated microangiopathy on haemostasis for women with HELLP diagnosis has been demonstrated.

Scientific problem resolved in this thesis: The precocious diagnostic and intensive treatment algorithm of HELLP syndrome has been created in the intensive therapy unit.

Theoretical significance and practical value of the thesis: The obtained results have demonstrated that HELLP syndrome frequently develops in MODS with maternal decease, which imposes the placement of pregnant patients in the intensive therapy unit once the syndrome is detected. The frequency of HELLP syndrome complications is directly proportional with severity degree of tardive gestosis as well as with associated infectious diseases.

Implementation of scientific results: The results of the reserch have been implemented in the process of teaching at faculty of Anaesthesiology and Reanimatology nr.2 of the State University of Medicine and Pharmacy „N.Testemiţanu" of the Republic of Moldova and in the daily activity of reanimation departments of IMSP SCR, IMSP SCM nr.1, IMSP ICŞDOSMşiC.