• Paulino Vigil-De Gracia.
• Critical Care Unit, Department of Obstetrics and Gynecology, Caja de Seguro Social, Panama, Panama.
• Int J Gynaecol Obstet. 2009 Feb 1; 104 (2): 90-4.

ObjectiveTo evaluate maternal deaths associated with eclampsia, HELLP syndrome, and the concurrence of these conditions.MethodA review of Medline studies reporting maternal deaths associated with eclampsia or HELLP syndrome published in English, Spanish, and Portuguese between 1995 and June 2008.ResultsA total of 304 deaths were identified: 100 due to eclampsia, 117 due to eclampsia/HELLP, and 87 associated with HELLP syndrome. Of the total deaths, 71.3% of women had seizures and 67.1% developed HELLP syndrome. In high-income countries 3.9% of deaths were due to eclampsia without HELLP syndrome, while in low-income countries this figure was 42.5% (P<0.0001). The presence of HELLP syndrome in the women who died of eclampsia was 90.6% (29/32) in high-income countries compared with 47.6% (88/185) in low-income countries (P<0.001).ConclusionConcurrent eclampsia and HELLP syndrome was diagnosed in 5-6 out of 10 deaths associated with eclampsia or HELLP syndrome in this review.

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